Operations research for resource planning and -use in radiotherapy: a literature review

Abstract

BackgroundThe delivery of radiotherapy (RT) involves the use of rather expensive resources and multi-disciplinary staff. As the number of cancer patients receiving RT increases, timely delivery becomes increasingly difficult due to the complexities related to, among others, variable patient inflow, complex patient routing, and the joint planning of multiple resources. Operations research (OR) methods have been successfully applied to solve many logistics problems through the development of advanced analytical models for improved decision making. This paper presents the state of the art in the application of OR methods for logistics optimization in RT, at various managerial levels.MethodsA literature search was performed in six databases covering several disciplines, from the medical to the technical field. Papers included in the review were published in peer-reviewed journals from 2000 to 2015. Data extraction includes the subject of research, the OR methods used in the study, the extent of implementation according to a six-stage model and the (potential) impact of the results in practice.ResultsFrom the 33 papers included in the review, 18 addressed problems related to patient scheduling (of which 12 focus on scheduling patients on linear accelerators), 8 focus on strategic decision making, 5 on resource capacity planning, and 2 on patient prioritization. Although calculating promising results, none of the papers reported a full implementation of the model with at least a thorough pre-post performance evaluation, indicating that, apart from possible reporting bias, implementation rates of OR models in RT are probably low.ConclusionsThe literature on OR applications in RT covers a wide range of approaches from strategic capacity management to operational scheduling levels, and shows that considerable benefits in terms of both waiting times and resource utilization are likely to be achieved. Various fields can be further developed, for instance optimizing the coordination between the available capacity of different imaging devices or developing scheduling models that consider the RT chain of operations as a whole rather than the treatment machines alone.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-016-0390-4) contains supplementary material, which is available to authorized users.

Effect of radiotherapy on the chemical composition of root dentin

“…Thus, radiotherapy is widely used either as primary therapy, as adjuvant therapy, or as palliative treatment on the final and inoperable stages of the disease . Radiation therapy uses radioactive elements and high energy radiations produced by X‐ray equipment and particle accelerators that act directly by promoting rupture of the deoxyribonucleic acid chains, or indirectly in the production of free radicals and hydrogen peroxide resulting from the physical action of gamma irradiation in the water, leading to cellular necrosis . During radiation therapy for head and neck cancer, healthy surrounding tissues such as bones, mucosa, teeth, and salivary glands are hardly preserved …”

The influence of automation on tumor contouring

“…The image co-registration step is then followed by the contouring task, during which the various treatment volumes, i.e., the tumor, as well as the surrounding healthy tissues are contoured by a physician(s) (Vieira et al 2016). One of the axioms of radiotherapy is to maximize the prescribed radiation dose to the tumor while sparing surrounding organs at risk (Burnet 2004).…”

“…The planning of radiotherapy involves a number of clinicians and tasks (Vieira et al 2016). Once radiotherapy is suggested based on the diagnosis and is discussed with the patient, the necessary data for the treatment planning, such as medical image datasets of different modalities (Batumalai et al 2016), are acquired.…”

“…During this task, the tumor and the surrounding organs at risk are contoured on the medical images by a physician (Vieira et al 2016). Manual contouring can be tedious and time-consuming (Dowsett et al 1992;Vorwerk et al 2014), and introducing automatic contouring tools (i.e., contouring with the support of automation) is generally expected to decrease the task duration (Lim and Leech 2016).…”

A mathematical programming model for optimizing the staff allocation in radiotherapy under uncertain demand

“…Operations research (OR) methods have been proposed to optimize resource planning and control in RT, as shown by Vieira et al (2016). In their review, it is shown that although most of the published studies focus on the scheduling of treatment sessions (such as Conforti et al (2010), Sauré et al (2012), and ), greater benefits in terms of waiting time reduction and resource utilization can be achieved if the pre-treatment stage is optimized jointly.…”