Minimizing metastatic risk in radiotherapy fractionation schedules

 

Metastasis is the process by which cells from a primary tumor disperse and form new tumors at distant anatomical locations. The treatment and prevention of metastatic cancer remains an extremely challenging problem. In this work, we consider the problem of developing fractionated irradiation schedules that minimize production of metastatic cancer cells. Interestingly we observe that the resulting fractionation schedules are sig- nificantly different than those that result from more standard objectives such as minimization of final primary tumor volume. Hypo-fractionation is suggested even in cases when the α/β value of the tumor is large. This work introduces a novel biologically motivated objective function to the radiation optimization community that takes into account metastatic risk instead of the status of the primary tumor. This is based on joint work with Jagdish Ramakrishnan.