Predicting normal tissue toxicity following radiotherapy is a multidimensional challenge. The dose received by healthy tissue surrounding the tumour is described using a 3D dose distribution. In addition, patient-and treatment-related factors must also be considered in any predictive model of toxicity. Mixing these complex and disparate data types is a challenge that can be addressed with machine learning. This chapter introduces the concept of normal tissue complication probability (NTCP) and reviews literature related to the use of machine learning in this field.
NTCP ModellingThe response of normal tissue incidentally and unavoidably irradiated during radiotherapy is the main factor limiting the increase in prescription dose to the tumour. Optimising this trade-off, known as the therapeutic ratio, is the fundamental challenge in radiotherapy (Fig. 17.1). Although complimentary in approach, the complexity of predicting normal tissue response is a higher dimensional problem than predicting local control. The reasons for this are (1) there are usually more than one organ at risk irradiated and protecting all of these structures requires compromise, (2) each structure responds differently to radiotherapy due to the type of cells and the structural and functional organisation of the tissue, and (3) the dose distributions to the surrounding normal tissues are inhomogeneous with gradients