Design of an optimization algorithm for clinical use

Radiation therapy optimization has received much attention in the past few years. In combination with biological objective functions, the different optimization schemes has shown a potential to considerably increase the treatment outcome. With improved radiobiological models and increased computer capacity, radiation therapy optimization has now reached a stage where implementation in a clinical treatment planning system is realistic. A radiation therapy optimization method has been investigated with respect to its feasibility as a tool in a clinical 3D treatment planning system. The optimization algorithm is a constrained iterative gradient method. Photon dose calculation is performed using the clinically validated pencil-beam based algorithm of the clinical treatment planning system. Dose calculation within the optimization scheme is very time consuming and measures are required to decrease the calculation time. Different methods for more effective dose calculation within the optimization scheme have been investigated. The optimization results for adaptive sampling of calculation points, and secondary effect approximations in the dose calculation algorithm are compared with the optimization result for accurate dose calculation in all voxels of interest