Stochastic Models For Evolution Of Tumor Geometry for Cervical Cancer During Radiation Therapy

Adaptive radiation therapy re-optimizes treatment plans based on updated tumor geometries from magnetic resonance imaging scans. However, the imaging process is costly in labor and equipment. In this study, we develop a mathematical model that describes tumor evolution based on a Markov assumption. We then extend the model to predict tumor evolution with any level of information from a new patient: weekly MRI scans are used to estimate transition probabilities when available, otherwise historical MRI scans are used. In the latter case, patients in the historical data are clustered into two groups, and the model relates the new patient's behavior to the existing two groups. The models are evaluated with 33 cervical cancer patients from Princess Margaret Cancer Centre. The result indicates that our models outperform the constant volume model, which replicates the current clinical practice.MAS