On-line strategy of daily dose prescription in adaptive radiotherapy

One of the major impediments to radiation treatment optimization is the inherent variability of patient and organ geometry during the course of radiation dose delivery. To overcome this obstacle, advanced technologies to facilitate image guidance and intensity modulated beam delivery are being rapidly developed. With these technologies, patient geometric variations can be repeatedly detected, and radiation dose can be better conformed to the target. However, accompanying the improving technology is a new challenge to the radiotherapy community, namely, how to utilize the information in daily patient images to maximize the treatment outcome. In this study, a new treatment strategy is proposed by utilizing daily volumetric image feedback in adaptive radiotherapy process. Utilizing daily image feedback and IMRT delivery, biological effective dose of the individual is optimized by means of selecting daily dose fraction and total number of fractions