Adaptive Objective Configuration in Bi-Objective Evolutionary Optimization for Cervical Cancer Brachytherapy Treatment Planning

TL;DR

This paper introduces an adaptive objective configuration method for bi-objective evolutionary optimization in cervical cancer brachytherapy, enabling personalized treatment planning that aligns with clinical preferences and improves expert approval.

Contribution

It proposes a novel adaptive objective configuration approach for MO-RV-GOMEA, accommodating additional clinical aims and patient-specific preferences in cervical cancer brachytherapy planning.

Findings

The new method achieved preferred plans in 8 out of 10 cases.

It effectively incorporates additional clinical aims beyond the base protocol.

The approach enhances the clinical relevance of optimized treatment plans.

Abstract

The Multi-Objective Real-Valued Gene-pool Optimal Mixing Evolutionary Algorithm (MO-RV-GOMEA) has been proven effective and efficient in solving real-world problems. A prime example is optimizing treatment plans for prostate cancer brachytherapy, an internal form of radiation treatment, for which equally important clinical aims from a base protocol are grouped into two objectives and bi-objectively optimized. This use of MO-RV-GOMEA was recently successfully introduced into clinical practice. Brachytherapy can also play an important role in treating cervical cancer. However, using the same approach to optimize treatment plans often does not immediately lead to clinically desirable results. Concordantly, medical experts indicate that they use additional aims beyond the cervix base protocol. Moreover, these aims have different priorities and can be patient-specifically adjusted. For this reason, we propose a novel adaptive objective configuration method to use with MO-RV-GOMEA so that we can accommodate additional aims of this nature. Based on results using only the base protocol, in consultation with medical experts, we configured key additional aims. We show how, for 10 patient cases, the new approach achieves the intended result, properly taking into account the additional aims. Consequently, plans resulting from the new approach are preferred by medical specialists in 8/10 cases.