Abstract
The most efficient but also least developed area of treatment optimization is to use a few (≈3) non uniform radiation beams directed towards the tumor. Today patient individual collimation with beam blocks or multileaf collimators protect organs at risk laterally outside the tumor volume. Non uniform dose delivery also allows protection of normal tissues anterior, posterior and even inside the target volume by shaping the isodoses tightly around the tumor tissues and thereby also allowing longitudinal protection of normal tissues. Some of the most advanced new algorithms are even treating therapy optimization as an inverse problem where the optimal incident beam shapes are determined directly from the location of gross disease, presumed microscopic tumor spread and organs at risk. The optimization is then performed such that the probability, P<sub>+</sub>, to eradicate all clonogenic tumor cells without severely damaging healthy normal tissues is as high as possible.
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