  The purpose of this study is to examine in a clinical setting a novel
formulation of objective functions for intensity-modulated radiotherapy
treatment plan multicriteria optimization (MCO) that we suggested in a recent
study. The proposed objective functions are extended with dynamic multileaf
collimator (DMLC) delivery constraints from the literature, and a tailored
interior point method is described to efficiently solve the resulting
optimization formulation. In a numerical planning study involving three patient
cases, DMLC plans Pareto optimal to the MCO formulation with the proposed
objective functions are generated. Evaluated based on pre-defined plan quality
indices, these DMLC plans are compared to conventionally generated DMLC plans.
Comparable or superior plan quality is observed. Supported by these results,
the proposed objective functions are argued to have a potential to streamline
the planning process, since they are designed to overcome the methodological
shortcomings associated with the conventional penalty-based objective functions
assumed to cause the current need for time-consuming trial-and-error parameter
tuning. In particular, the increased accuracy of the planning tools imposed by
the proposed objective functions has the potential to make the planning process
less complicated. These conclusions position the proposed formulation as an
alternative to existing methods for automated planning.
