Optimal solution for a cancer radiotherapy problem

We address the problem of finding the optimal radiotherapy fractionation scheme, representing the response to radiation of tumour and normal tissues by the LQ model including exponential repopulation and sublethal damage due to incomplete repair. We formulate the nonlinear programming problem of maximizing the overall tumour damage, while keeping the damages to the late and early responding normal tissues within a given admissible level. The optimum is searched over a single week of treatment and its possible structures are identified. In the two simpler but important cases of absence of the incomplete repair term or of prevalent late constraint, we prove the uniqueness of the optimal solution and we characterize it in terms of model parameters. The optimal solution is found to be not necessarily uniform over the week. The theoretical results are confirmed by numerical tests and comparisons with literature fractionation schemes are presented.