Book chapter
Using Quality of Life Information to Rationally Incorporate Normal Tissue Effects into Treatment Plan Evaluation and Scoring
pp.83-89
Medical Radiology-Radiation Oncology, Springer Nature
01 Jan 2008
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Sophisticated planning systems now readily provide the treatment planner with an increasing number of competing treatment plans. There is, however, no generally accepted method to compare and rank these competing treatment plans. A "realistic" approach utilizing decision analysis tools to rank treatment plans based on quality adjusted life years (QALY) expectancy was developed. The decision analysis methods were applied to the concept of uncomplicated tumor control probability (UTCP). The expected outcome for an anticipated course of radiation was described as a series of probabilities: alive, free of disease without complication; alive with disease; alive with complication, etc. For each of these states of health, a utility can be assigned based on published work or empirical estimates. The total QALYs for a particular treatment plan represent the product of duration-weighted states of health. The formalism for UTCP was generalized to incorporate the total QALY (UTCPQALY) for a particular treatment. This approach was applied to compare competing treatment plans for a patient receiving high-dose external beam irradiation for unresectable non-small cell lung cancer. The plan ranking based on the traditional UTCP and QALY-weighted UTCP (UTCPQALY) values was different. The QALY-weighted UTCP better reflects the importance of tumor control over mild complication, by giving less weight to the latter. This was confirmed by applying the method to clinical data from 201 lung cancer patients, 39 of whom developed radiation-induced pneumonitis (RP). The construct presented represents a potential improvement in the current methods used to compare competing treatment plans. Formulas presented are straightforward and can be readily incorporated into treatment planning systems.
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Details
- Title
- Using Quality of Life Information to Rationally Incorporate Normal Tissue Effects into Treatment Plan Evaluation and Scoring
- Creators
- Moyed Miften - Allegheny Gen Hosp, Dept Radiat Oncol, Pittsburgh, PA 15212 USAOlivier Gayou - Allegheny Gen Hosp, Dept Radiat Oncol, Pittsburgh, PA 15212 USADavid S. Parda - Allegheny Gen Hosp, Dept Radiat Oncol, Pittsburgh, PA 15212 USARobert Prosnitz - Duke Univ, Med Ctr, Dept Radiat Oncol, Durham, NC 27710 USALawrence B. Marks - Duke Univ, Med Ctr, Dept Radiat Oncol, Durham, NC 27710 USA
- Contributors
- P Rubin (Editor)L S Constine (Editor)L B Marks (Editor)P Okunieff (Editor)
- Publication Details
- pp.83-89
- Series
- Medical Radiology-Radiation Oncology
- Publisher
- Springer Nature; BERLIN
- Number of pages
- 7
- Resource Type
- Book chapter
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Identifiers
- 991019170116304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging