Automated Radiotherapy Treatment Planning

The "treatment planning" component of managing a radiotherapy patient currently consumes hours, even days, of human effort. The time and workforce demands of the current planning paradigm can expose patients to delays and potentially substandard treatments, all while standing as seemingly insurmountable roadblocks to adaptive radiotherapy. Automating the treatment planning process is not a new idea, but recent advances have shown that automated planning might finally be turning the corner from niche research endeavor to a standard clinical practice. In this Seminar, we will examine the current state of automated radiotherapy planning, taking particular care to consider the most critical component of the planning problem: how to generate high-quality treatment solutions that account for patient-to-patient anatomical variation. Recommendations for testing and validating automated planning routines will be discussed, as well as potential drawbacks that might persist even after robust validation has been conducted. (C) 2019 Elsevier Inc. All rights reserved.