ABSTRACT
Radiotherapy, in theory, deals with large disease masses by simply increasing the dose, and is relatively less sensitive to clonal and microenvironmental heterogeneity, although these are important factors. Optimized radiotherapy represents a way to improve outcomes, even if only incrementally, without dramatically increasing the cost of care. Due to disease and anatomic variability between patients, the prescription dose to achieve a high probability of local control with an acceptably low risk of morbidity, is patient-specific. However, tumor control probability and normal tissue complication probability models could be used to individually optimize treatment planning despite these variations. The work of Jeho Jeong is an example of a more sophisticated tumor state-simulation model that attempts to capture a mechanistic picture of tumor evolution in response to a radiotherapy regime. The model assumes that each voxel of the tumor has a limited vascular capacity to deliver nutrients.
