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Updated: Feb 12, 2026

Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System
Published on: April 11, 2018
A Treatment Planning Method for Better Management of Radiation-Induced Oral Mucositis in Locally Advanced Head and
Hao Howard Zhang1, Warren D D'Souza1
1Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA.
Purpose/Aim:
To describe a two-phase intensity-modulated radiation therapy (IMRT) treatment planning approach, that is, promising for reduction of oral mucositis risk in locally advanced head-and-neck cancer.
Materials And Methods:
Ten locally advanced head-and-neck cancer patients who underwent RT were retrospectively collected. Conventional IMRT and volumetric-modulated arc therapy (VMAT) plans were generated for these patients following clinical protocol. Following the first phase of generating conventional IMRT plans, our approach utilized data from Monte Carlo-based kernel superposition dose calculations corresponding to beam apertures (generated from the conventional IMRT plans) and used an exact mathematical programming-based optimization approach applying linear programming (LP) to dose optimization in the second phase.
Results:
Compared with conventional IMRT and VMAT treatment plans, our novel method achieved better preservation of oral cavity (16%-29% lower mean dose, P < 0.01), parotid glands (6%-17% lower mean dose, P < 0.04), and spinal cord (3-11 Gy lower maximum dose, P < 0.03) and lower doses to nonorgan-at-risk/nontarget normal tissues, with the same or better target coverage.
Conclusions:
Our LP-based method can be practically implemented in routine clinical use with a goal of limiting radiation-induced oral mucositis for head-and-neck cancer patients.
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