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Application of IGRT for lung stereotactic body radiotherapy
Published in Jing Cai, Joe Y. Chang, Fang-Fang Yin, Principles and Practice of Image-Guided Radiation Therapy of Lung Cancer, 2017
Julianne M. Pollard-Larkin, Peter Balter, Joe Y. Chang
IGRT has helped to improve the precision of treatments, and simultaneously initiated a new interest in previously controversial fractionation schemes. Standard classical dose fractionation schemes involve 1.8–2 Gy per fraction for 30 or more total fractions over 5 or more weeks. Long treatment times for the patients and machines caused researchers in the 1960s to consider hypofractionation for breast cancer treatment, however, the results of these studies showed pronounced unfavorable outcomes due to normal tissue complications in the 3-day-a-week treatment compared to the standard 5-day-a-week regimen [50]. The higher dose per fraction, shorter treatment regimens were more problematic due to reduced time allowed for normal tissue sub-lethal repair to occur between fractions. Modern radiotherapy techniques allow us to create highly conformal dose distributions minimizing normal tissue doses and toxicity while IGRT allows us to still have confidence of our ability to cover the target with these tight dose distributions.
Operator splitting for adaptive radiation therapy with nonlinear health dynamics
Published in Optimization Methods and Software, 2022
Anqi Fu, Lei Xing, Stephen Boyd
To achieve the best outcomes, radiation therapy must adapt to new information about the patient's health and anatomy during treatment. We have described one method for adaptive radiation treatment planning using an operator splitting algorithm. Our method is highly scalable, parallelizable, and can efficiently handle a large number of beams and sessions. Moreover, it is robust to errors in the patient's health response model, as well as other sources of uncertainty in the clinic. We demonstrated its effectiveness on a large prostate cancer case and showed that the resulting plan improves markedly on a standard equal-dose fractionation scheme.