title: Predicting outcomes in radiation oncology--multifactorial decision support systems.
abstract: With the emergence of individualized medicine and the increasing amount and complexity of available medical data, a growing need exists for the development of clinical decision-support systems based on prediction models of treatment outcome. In radiation oncology, these models combine both predictive and prognostic data factors from clinical, imaging, molecular and other sources to achieve the highest accuracy to predict tumour response and follow-up event rates. In this Review, we provide an overview of the factors that are correlated with outcome-including survival, recurrence patterns and toxicity-in radiation oncology and discuss the methodology behind the development of prediction models, which is a multistage process. Even after initial development and clinical introduction, a truly useful predictive model will be continuously re-evaluated on different patient datasets from different regions to ensure its population-specific strength. In the future, validated decision-support systems will be fully integrated in the clinic, with data and knowledge being shared in a standardized, instant and global manner.
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, 6229 ET, The Netherlands. philippe.lambin@maastro.nl
authors.forename: Philippe
authors.initials: P
authors.lastname: Lambin
authors.forename: Ruud G P M
authors.initials: RG
authors.lastname: van Stiphout
authors.forename: Maud H W
authors.initials: MH
authors.lastname: Starmans
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Rios-Velazquez
authors.forename: Georgi
authors.initials: G
authors.lastname: Nalbantov
authors.forename: Hugo J W L
authors.initials: HJ
authors.lastname: Aerts
authors.forename: Erik
authors.initials: E
authors.lastname: Roelofs
authors.forename: Wouter
authors.initials: W
authors.lastname: van Elmpt
authors.forename: Paul C
authors.initials: PC
authors.lastname: Boutros
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Granone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Valentini
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Begg
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ruysscher
authors.forename: Andre
authors.initials: A
authors.lastname: Dekker
mesh_terms: D020000:Decision Support Systems, Clinical; D006801:Humans; D008962:Models, Theoretical; D009369:Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D057285:Precision Medicine; D018787:Radiation Oncology; D016896:Treatment Outcome