title: Interactive decision-support tool for risk-based radiation therapy plan comparison for Hodgkin lymphoma.
abstract: OBJECTIVE
  To present a novel tool that allows quantitative estimation and visualization of the risk of various relevant normal tissue endpoints to aid in treatment plan comparison and clinical decision making in radiation therapy (RT) planning for Hodgkin lymphoma (HL).
  
  
  METHODS
  A decision-support tool for risk-based, individualized treatment plan comparison is presented. The tool displays dose-response relationships, derived from published clinical data, for a number of relevant side effects and thereby provides direct visualization of the trade-off between these endpoints. The Quantitative Analyses of Normal Tissue Effects in the Clinic reports were applied, complemented with newer data where available. A "relevance score" was assigned to each data source, reflecting how relevant the input data are to current RT for HL.
  
  
  RESULTS
  The tool is applied to visualize the local steepness of dose-response curves to drive the reoptimization of a volumetric modulated arc therapy treatment plan for an HL patient with head-and-neck involvement. We also use this decision-support tool to visualize and quantitatively evaluate the trade-off between a 3-dimensional conformal RT plan and a volumetric modulated arc therapy plan for a patient with mediastinal HL.
  
  
  CONCLUSIONS
  This multiple-endpoint decision-support tool provides quantitative risk estimates to supplement the clinical judgment of the radiation oncologist when comparing different RT options.
authors: Department of Radiation Oncology, Albert Einstein College of Medicine of Yeshiva University, New York, New York.
authors: N Patrik
authors: NP
authors: Brodin
authors: Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark. Electronic address: dra.maraldo@gmail.com.
authors: Maja V
authors: MV
authors: Maraldo
authors: Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark; Niels Bohr Institute, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Marianne C
authors: MC
authors: Aznar
authors: Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Ivan R
authors: IR
authors: Vogelius
authors: Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Hematology, Rigshospitalet, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Peter M
authors: PM
authors: Petersen
authors: Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Human Oncology, University of Wisconsin Medical School, Madison, Wisconsin.
authors: Søren M
authors: SM
authors: Bentzen
authors: Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Hematology, Rigshospitalet, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Lena
authors: L
authors: Specht
mesh_terms: D000293:Adolescent; D003661:Decision Support Techniques; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006689:Hodgkin Disease / Q000532:radiotherapy*; D006801:Humans; D008479:Mediastinal Neoplasms / Q000532:radiotherapy*; D008875:Middle Aged; D015233:Models, Statistical; D058958:Organs at Risk / Q000528:radiation effects*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D012306:Risk