Prostate cancer is a frequently diagnosed malignancy worldwide and radiation therapy is a first-line approach in treating localized as well as locally advanced cases. The limiting factor in modern radiotherapy regimens is dose to normal structures, an excess of which can lead to aberrant radiation-induced toxicities.
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Conversely, dose reduction to spare adjacent normal structures risks underdosing target volumes and compromising local control. As a result, efforts aimed at predicting the effects of radiotherapy could invaluably optimize patient treatments by mitigating such toxicities and simultaneously maximizing biochemical control. In this work, we review the types of data, frameworks and techniques used for prostate radiotherapy outcome modeling. Consideration is given to clinical and dose-volume metrics, such as those amassed by the QUANTEC initiative, and also to newer methods for the integration of biological and genetic factors to improve prediction performance. We furthermore highlight trends in machine learning that may help to elucidate the complex pathophysiological mechanisms of tumor control and radiation-induced normal tissue side effects.
Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB). 2016 Apr 01 [Epub ahead of print]
James Coates, Issam El Naqa
Department of Oncology, University of Oxford, Oxford, UK., Department of Radiation Oncology, University of Michigan, Ann Arbor, USA.