Smarter Radiation Therapy Enhances Personalized Care for Cancer Patients

The latest advance in radiation therapy, using artificial intelligence to adjust treatments as needed without delay, is now available for select cancer patients at Columbia University Irving Medical Center/NewYork-Presbyterian. The system is the first adaptive online radiation therapy available in the New York City area.

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 the many weeks of therapy.

“Patients can undergo many physical changes during radiation treatment; the size and shape of the tumor may start to change, the patient may lose a lot of weight, or nearby organs may shift position,” says Tony Wang, MD, professor of radiation oncology at Columbia University Vagelos College of Physicians and Surgeons. “Radiation oncologists have long recognized this issue, but we haven’t had the technological capability or computing power to recalculate the treatment plan quickly enough to account for these changes without causing a delay in treatment.”

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 risk of irradiating nearby healthy tissues.

“The benefits to the patient are potentially substantial,” says Michael Price, PhD, associate professor of radiation oncology at Columbia University Vagelos College of Physicians and Surgeons and director of the system’s installation at Columbia/NewYork-Presbyterian. “With conventional radiotherapy, if a tumor shrinks after several weeks of treatment, the patient still receives radiation designed for the full-sized tumor. We can create a new plan based on these changes, but it frequently leads to a pause in a patient’s course of treatment since it requires an additional CT scan and time to create a new plan from scratch.”

“With the new system, the plan is automatically recalculated based on the patient’s condition during each treatment, allowing us to offer a highly personalized treatment experience. That means potentially better cancer control while simultaneously reducing radiation side effects.”