Abstract
Sophisticated planning systems now readily provide the treatment planner with an increasing number of competing treatment plans. There is, however, no generally accepted method to compare and rank these competing treatment plans. A “realistic” approach utilizing decision analysis tools to rank treatment plans based on quality adjusted life years (QALY) expectancy was developed. The decision analysis methods were applied to the concept of uncomplicated tumor control probability (UTCP). The expected outcome for an anticipated course of radiation was described as a series of probabilities: alive, free of disease without complication; alive with disease; alive with complication, etc. For each of these states of health, a utility can be assigned based on published work or empirical estimates. The total QALYs for a particular treatment plan represent the product of duration-weighted states of health. The formalism for UTCP was generalized to incorporate the total QALY (UTCPQALY) for a particular treatment.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Kutcher GJ, Burman C, Brewster L et al (1991) Histogram reduction method for calculating complication probabilities for three-dimensional treatment planning evaluations. Int J Radiat Oncol Biol Phys 21:137–146
Leibel SA, Kutcher GJ, Harrison LB et al (1991) Improved dose distributions for 3D conformai boost treatments in carcinoma of the nasopharynx. Int J Radiat Oncol Biol Phys 20:823–833
Niemierko A, Urie M, Goitein M (1992) Optimization of 3D radiation therapy with both physical and biological end points and constraints. Int J Radiat Oncol Biol Phys 23:99–108
Photon Treatment Planning Collaborative Working Group (1991) State-of-the-art of external photon beam radiation treatment planning. Int J Radiat Oncol Biol Phys 21:9–23
Langer M, Morrill SS, Lane R (1998) A test of the claim that plan rankings are determined by relative complication and tumor-control probabilities. Int J Radiat Oncol Biol Phys 41:451–457
Jain NL, Kahn MG, Drzymala RE et al (1993) Objective evaluation of 3-D radiation treatment plans: a decisionanalytic tool incorporating treatment preferences of radiation oncologists. Int J Radiat Oncol Biol Phys 26:321–333
Niemierko A, Goitein M (1991) Calculation of normal tissue complication probability and dose-volume histogram reduction schemes for tissues with a critical element architecture. Radiother Oncol 20:166–176
Hollen PJ, Gralla RJ, Kris MG et al (1993) Measurement of quality of life in patients with lung cancer in multicenter trials of new therapies. Cancer 73:2087–2098
Rotman M, Johnson DJ, Wasserman TH (2004) Supportive care and quality of life in radiation oncology. In: Perez CA, Brady LW, Halperin EC, Schmidt-Ullrich RK (eds) Principles and practice of radiation oncology. Lippincott, Philadelphia, pp 2426–2441
Kaplan RM (1993) Quality of life assessment for cost/utility studies in cancer. Cancer Treat Rev 19:85–96
Loomes G, McKenzie L (1989) The use of QALYs in health care decision making. Soc Sci Med 28:299–308
Chang SX, Cullip TG, Rosenman JG et al (2002) Dose optimization via index-dose gradient minimization. Med Phys 29:1130–1142
Emami B, Lyman J, Brown A et al (1991) Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 21:109–122
Burman C, Kutcher GJ, Emami B et al (1991) Fitting of normal tissue tolerance data to an analytic function. Int J Radiat Oncol Biol Phys 21:123–135
Webb S, Nahum AE (1993) A model calculating tumor control probability in radiotherapy including the effects of inhomogeneous distributions of dose and clonogenic cell density. Phys Med Biol 38:653–666
Kwa SL, Lebesque JV, Theuws JC et al (1998) Radiation pneumonitis as a function of mean lung dose: an analysis of pooled data of 540 patients. Int J Radiat Oncol Biol Phys 42:1–9
Hernando ML, Marks LB, Bentel GC et al (2001) Radiation-induced pulmonary toxicity: a dose-volume histogram analysis in 201 patients with lung cancer. Int J Radiat Oncol Biol Phys 51:650–659
Etiz D, Marks LB, Zhou SM et al (2002) Influence of tumor volume on survival in patients irradiated for non-small-cell lung cancer. Int J Radia Oncol Biol Phys 53:835–846
Marks LB, Fan M, Clough R et al (2000) Radiation induced pulmonary injury: symptomatic verses subclinical endpoints. Int J Radiat Biology 76:469–475
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Miften, M., Gayou, O., Parda, D.S., Prosnitz, R., Marks, L.B. (2008). Using Quality of Life Information to Rationally. In: Rubin, P., Constine, L.S., Marks, L.B., Okunieff, P. (eds) Late Effects of Cancer Treatment on Normal Tissues. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-49070-8_11
Download citation
DOI: https://doi.org/10.1007/978-3-540-49070-8_11
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-49069-2
Online ISBN: 978-3-540-49070-8
eBook Packages: MedicineMedicine (R0)