Fast treatment plan modification with an over-relaxed Cimmino algorithm.

A method to quickly modify a treatment plan in adaptive radiotherapy was proposed and studied. The method is based on a Cimmino-type algorithm in linear programming. The fast convergence speed is achieved by over-relaxing the algorithm relaxation parameter from its sufficient convergence range of (0, 2) to (0, infinity). The algorithm parameters are selected so that the over-relaxed Cimmino (ORC) algorithm can effectively approximate an unconstrained re-optimization process in adaptive radiotherapy. To demonstrate the effectiveness and flexibility of the proposed method in adaptive radiotherapy, two scenarios with different organ motion/deformation of one nasopharyngeal case were presented with comparisons made between this method and the re-optimization method. In both scenarios, the ORC algorithm modified treatment plans have dose distributions that are similar to those given by the re-optimized treatment plans. It takes us using the ORC algorithm to finish a treatment plan modification at least three times faster than the re-optimization procedure compared.