Smarter Radiation Therapy for Cancer Patients

The latest advance in radiation therapy—using artificial intelligence to adjust treatments as needed without delay—is now available for select patients at Columbia. The new advance solves a long-standing issue in radiation oncology: the difficulty of adapting treatment to anatomical changes in the patient or the tumor that can occur during many weeks of therapy.

“Patients may undergo physical changes during radiation treatment—the size and shape of the tumor may start to change, the patient may lose weight, or nearby organs may shift position,” says Tony Wang, MD, professor of radiation oncology at VP&S. 

With the new system, known as adaptive online radiation therapy, patients under­going weeks of radiation treatment may have their treatment plan reassessed and optimized before every session, allowing the maximal radiation dose to be delivered to the tumor while reducing the dose to nearby healthy tissues.

At the beginning of each treatment, 3D CT imaging identifies changes in the patient’s anatomy—including the tumor and nearby structures—that have occurred since the patient was last treated. A machine learning module then automatically recalculates the plan based on the patient’s changed anatomy.

Each recalculated treatment plan is reviewed and approved by the radiation therapy team before it is implemented. The entire process adds only a few minutes to each treatment.

“The adaptive radiotherapy system predicts what the treatment team would do when faced with the patient’s anatomy on the day of treatment versus day zero, giving us the ability to align the plan to the patient,” says Michael Price, PhD, associate professor of radiation oncology at VP&S and director of the system’s installation at Columbia.

The adaptive radiotherapy system is being used to treat patients with anal, cervical, rectal, and prostate cancers, which are located near organs that frequently change in volume, such as the bladder, bowel, and colon. The system also may be used to treat head and neck cancers and other tumors that tend to shrink quickly when treated with radiation.

For more information, contact the Department of Radiation Oncology at (212) 305-7077.