Deep Reinforcement Learning for Fractionated Radiotherapy in Non-Small Cell Lung Carcinoma.

Lung cancer is by far the leading cause of cancer death among both men and women. Radiation therapy is one of the main approaches to lung cancer treatment, and its planning is crucial for the therapy outcome. However, the current practice that uniformly delivers the dose does not take into account t...

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Published in:Artificial Intelligence in Medicine Vol. 119
Main Authors: Tortora, Matteo, Cordelli, Ermanno, Sicilia, Rosa, Miele, Marianna, Matteucci, Paolo, Iannello, Giulio, Ramella, Sara, Soda, Paolo
Format: research Journal Article
Published: Elsevier B.V. Sep2021
Online Access:View this record in EBSCOhost
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      dt: Sep2021
      vid: 119
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      pub: Elsevier B.V.
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        10.1016/j.artmed.2021.102137
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        atl: Deep Reinforcement Learning for Fractionated Radiotherapy in Non-Small Cell Lung Carcinoma.
      aug:
        au:
          Tortora, Matteo
          Cordelli, Ermanno
          Sicilia, Rosa
          Miele, Marianna
          Matteucci, Paolo
          Iannello, Giulio
          Ramella, Sara
          Soda, Paolo
        affil: Unit of Computer Systems & Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128, Roma, Italy
      sug:
        subj:
          Carcinoma, Non-Small-Cell Lung Radiotherapy
          Lung Neoplasms Radiotherapy
          Human
          Radiotherapy, Computer-Assisted
          Radiation Dosage
          Female
          Male
          Comparative Studies
          Multicenter Studies
          Female
          Male
      ab: Lung cancer is by far the leading cause of cancer death among both men and women. Radiation therapy is one of the main approaches to lung cancer treatment, and its planning is crucial for the therapy outcome. However, the current practice that uniformly delivers the dose does not take into account the patient-specific tumour features that may affect treatment success. Since radiation therapy is by its very nature a sequential procedure, Deep Reinforcement Learning (DRL) is a well-suited methodology to overcome this limitation. In this respect, in this work we present a DRL controller optimizing the daily dose fraction delivered to the patient on the basis of CT scans collected over time during the therapy, offering a personalized treatment not only for volume adaptation, as currently intended, but also for daily fractionation. Furthermore, this contribution introduces a virtual radiotherapy environment based on a set of ordinary differential equations modelling the tissue radiosensitivity by combining both the effect of the radiotherapy treatment and cell growth. Their parameters are estimated from CT scans routinely collected using the Particle Swarm Optimization algorithm. This permits the DRL to learn the optimal behaviour through an iterative trial and error process with the environment. We performed several experiments considering three rewards functions modelling treatment strategies with different tissue aggressiveness and two exploration strategies for the exploration-exploitation dilemma. The results show that our DRL approach can adapt to radiation therapy treatment, optimizing its behaviour according to the different reward functions and outperforming the current clinical practice.
      pubtype: Academic Journal
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        Journal Article
      ougenre: Article
    language: English
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