Radiotherapy is one of the most important treatments for cancer but the high dose of radiation used to destroy cancer cells can also damage adjacent healthy cells. As a result, classic treatment planning is a lengthy, repetitive process as clinicians and planners strive to identify the best option for each patient, balancing the need for maximum tumour coverage (for curative or palliative intent) and minimum risk to other organs and side-effects. The Fraunhofer Institute for Industrial Mathematics ITWM has developed a real-time decision support tool that evaluates the optimal compromise between these clinical trade-offs. Its interactive Multi-Criteria Optimisation (MCO) software for radiotherapy planning enables clinicians to create high-quality plans for even the most complex cases in a fraction of the time. For patients, the new approach leads to improved long-term survival rates, fewer side effects and better quality of life.
About 50% of all cancer patients could benefit from Fraunhofer’s new radiotherapy planning tool
The new tool reduces treatment planning time by up to 80% and increases plan quality by up to 30%
Radiotherapy planning is carried out on an estimated 36,000 planning devices worldwide
To date, Fraunhofer has received revenue of more than €8.5M from worldwide sales of the tool
Getting the right balance
To optimise radiotherapy treatment plans, clinicians have traditionally specified the desired compromise of the various planning goals. Those are used to manually create a few plans. The clinician then assesses these plans. The process can be repeated again and again. Not only does this ‘human iteration loop’ take a great deal of time; it frequently ends with the unsatisfactory option to deliver the last generated plan. Even if the loop ends with an acceptable plan, it is completely unknown if this plan fully exploits the curative potential for the patient.
Simulating optimised options
EARTO member Fraunhofer ITWM developed a software tool based on application-specific optimisation methods to support a process that overcomes these drawbacks. This enables the fast computation of a variety of therapy plans that meet the planning goals specified by the clinician, each featuring a different clinical compromise. These are prepared in advance so that when the clinician is ready to explore a case-specific option they can visually evaluate the optimised plans and trade-offs in real time using slider bars to vary parameters. The need for back and forth between planner and clinician is thus eliminated – and the chance to quickly identify the best plan is increased.
Reaching patients worldwide
Fraunhofer’s invention has caused a paradigm shift in clinical routine and the efficacy and safety of radiotherapy treatment. Users report a 30% reduction in radiation dose to organs at risk and improved tumour coverage. Fraunhofer’s industrial collaborator, Varian Medical Systems, is taking the MCO-enhanced version of its Eclipse treatment planning system to customers worldwide and aims to establish interactive MCO as the gold standard in radiotherapy planning. ITWM and Varian are also exploring how the tool can be used to adapt Eclipse treatment plans in clinic with the patient, giving them confidence they will benefit from the best possible plan.