Towards Personalized Prostate Cancer Therapy Using Delta-Reachability Analysis

Recent clinical studies suggest that the efficacy of hormone therapy for prostate cancer depends on the characteristics of individual patients. In this paper, we develop a computational framework for identifying patient-specific androgen ablation therapy schedules for postponing the potential cancer relapse. We model the population dynamics of heterogeneous prostate cancer cells in response to androgen suppression as a nonlinear hybrid automaton. We estimate personalized kinetic parameters to characterize patients and employ $\delta$-reachability analysis to predict patient-specific therapeutic strategies. The results show that our methods are promising and may lead to a prognostic tool for personalized cancer therapy.Comment: HSCC 201

Comparing Optimization Methods for Radiation Therapy Patient Scheduling using Different Objectives

Radiation therapy (RT) is one of the most common technologies used to treat cancer. To better use resources in RT, optimization models can be used to automatically create patient schedules, a task that today is done manually in almost all clinics. This paper presents a comprehensive study of different optimization methods for modeling and solving the RT patient scheduling problem. The results can be used as decision support when implementing an automatic scheduling algorithm in practice. We introduce an Integer Linear Programming (IP) model, a column generation IP model (CG-IP), and a Constraint Programming model. Patients are scheduled on multiple machine types considering their priority for treatment, session duration and allowed machines, while taking expected future patient arrivals into account. Different cancer centers may have different scheduling objectives, and therefore each model is solved using multiple different objective functions, including minimizing waiting times, and maximizing the fulfillment of patients' preferences for treatment times. The test data is generated from historical data from Iridium Netwerk, a large cancer center in Belgium with 10 linear accelerators. The results demonstrate that the CG-IP model can solve all the different problem instances to a mean optimality gap of less than 1% within one hour. The proposed methodology provides a tool for automated scheduling of RT treatments and can be generally applied to RT centers.Comment: 20 pages, 4 figures, Submitted to Operations Research Foru

Automated Diagnosis of Clinic Workflows

Outpatient clinics often run behind schedule due to patients who arrive late or appointments that run longer than expected. We sought to develop a generalizable method that would allow healthcare providers to diagnose problems in workflow that disrupt the schedule on any given provider clinic day. We use a constraint optimization problem to identify the least number of appointment modifications that make the rest of the schedule run on-time. We apply this method to an outpatient clinic at Vanderbilt. For patient seen in this clinic between March 27, 2017 and April 21, 2017, long cycle times tended to affect the overall schedule more than late patients. Results from this workflow diagnosis method could be used to inform interventions to help clinics run smoothly, thus decreasing patient wait times and increasing provider utilization

Head and neck cancer: metronomic chemotherapy

In the era of personalized medicine, head and neck squamous cell carcinoma (HNSCC) represents a critical oncologic topic. Conventional chemotherapy regimens consist of drugs administration in cycles near or at the maximum tolerated dose (MDT), followed by a long drug-free period to permit the patient to recover from acute toxicities. Despite this strategy is successful in controlling the cancer process at the beginning, a significant number of HNSCC patients tend to recurred or progress, especially those patients with locally advanced or metastatic disease. The repertoire of drugs directed against tumor cells has greatly increased and metronomic chemotherapy (MC) could be an effective treatment option.It is the purpose of this article to review the concept of MC and describe its potential use in HNSCC. We provide an update of ongoing progress and current challenges related to this issue

Targeted radiotherapy of neuroblastoma: future directions

No abstract available

An Automatic and Intelligent System for Integrated Healthcare Processes Management

In this work, an automatic and intelligent system for integrated healthcare processes management is developed on a constraint based system. This project has been carried out in collaboration with a real assisted repro-duction clinic. Our goal is to improve the efficiency of the clinic by facilitating the management of the integrated healthcare system. This is very important in an environment in which the healthcare processes present complex temporal and resource constraints.Ministerio de Economía y Competitividad TIN2016-76956-C3-2-RMinisterio de Economía y Competitividad TIN2015-71938-RED