An iterative approach to plan combination in radiotherapy

Radiation therapy concerns the delivery of a proper dose of radiation to a tumor volume without causing irreparable damage to surrounding healthy tissue and critical organs. The problem of plan combination in radiation therapy treatment planning (RTTP) proposed, formulated and studied here, addresses a situation when for a specific clinical case, a set of several treatment plans is proposed, but each one of them violates the prescribed dose in at least one significant region of the volume that has to be treated. We represent treatment plans as vectors in the Euclidean space, and define their equivalence, acceptability and realizability. A simple linear algebraic model for combining them is then used in order to derive, from the given set of approximate plans, a combined treatment plan, which will be both acceptable, and technically realizable. In the event that such a combined plan dose not exist, the alternatives for relaxing the treatment requirements can be systematically considered.