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Dosimetry robustness with stochastic optimization

All radiation therapy treatment planning relies on accurate dose calculation. Uncertainties in dosimetric prediction can significantly degrade an otherwise optimal plan. In this work, we introduce a robust optimization method which handles dosimetric errors and warrants for high-quality IMRT plans. Unlike other dose error estimations, we do not rely on the detailed knowledge about the sources of the uncertainty and use a generic error model based on random perturbation. This generality is sought in order to cope with a large variety of error sources. We demonstrate the method on a clinical case of lung cancer and show that our method provides plans that are more robust against dosimetric errors and are clinically acceptable. In fact, the robust plan exhibits a two-fold improved equivalent uniform dose compared to the non-robust but optimized plan. The achieved speedup will allow computationally extensive multi-criteria or beam-angle optimization approaches to warrant for dosimetrically relevant plans.