Autonomous Radiotherapy Treatment Planning Using DOLA: A Privacy-Preserving, LLM-Based Optimization Agent

Fuente: arXiv
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Main Authors: Nusrat, Humza, Luo, Bing, Hall, Ryan, Kim, Joshua, Bagher-Ebadian, Hassan, Doemer, Anthony, Movsas, Benjamin, Thind, Kundan
Format: Preprint
Published: 2025
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author Nusrat, Humza
Luo, Bing
Hall, Ryan
Kim, Joshua
Bagher-Ebadian, Hassan
Doemer, Anthony
Movsas, Benjamin
Thind, Kundan
author_facet Nusrat, Humza
Luo, Bing
Hall, Ryan
Kim, Joshua
Bagher-Ebadian, Hassan
Doemer, Anthony
Movsas, Benjamin
Thind, Kundan
contents Radiotherapy treatment planning is a complex and time-intensive process, often impacted by inter-planner variability and subjective decision-making. To address these challenges, we introduce Dose Optimization Language Agent (DOLA), an autonomous large language model (LLM)-based agent designed for optimizing radiotherapy treatment plans while rigorously protecting patient privacy. DOLA integrates the LLaMa3.1 LLM directly with a commercial treatment planning system, utilizing chain-of-thought prompting, retrieval-augmented generation (RAG), and reinforcement learning (RL). Operating entirely within secure local infrastructure, this agent eliminates external data sharing. We evaluated DOLA using a retrospective cohort of 18 prostate cancer patients prescribed 60 Gy in 20 fractions, comparing model sizes (8 billion vs. 70 billion parameters) and optimization strategies (No-RAG, RAG, and RAG+RL) over 10 planning iterations. The 70B model demonstrated significantly improved performance, achieving approximately 16.4% higher final scores than the 8B model. The RAG approach outperformed the No-RAG baseline by 19.8%, and incorporating RL accelerated convergence, highlighting the synergy of retrieval-based memory and reinforcement learning. Optimal temperature hyperparameter analysis identified 0.4 as providing the best balance between exploration and exploitation. This proof of concept study represents the first successful deployment of locally hosted LLM agents for autonomous optimization of treatment plans within a commercial radiotherapy planning system. By extending human-machine interaction through interpretable natural language reasoning, DOLA offers a scalable and privacy-conscious framework, with significant potential for clinical implementation and workflow improvement.
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id arxiv_https___arxiv_org_abs_2503_17553
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Autonomous Radiotherapy Treatment Planning Using DOLA: A Privacy-Preserving, LLM-Based Optimization Agent
Nusrat, Humza
Luo, Bing
Hall, Ryan
Kim, Joshua
Bagher-Ebadian, Hassan
Doemer, Anthony
Movsas, Benjamin
Thind, Kundan
Medical Physics
Artificial Intelligence
Computation and Language
Emerging Technologies
Human-Computer Interaction
Radiotherapy treatment planning is a complex and time-intensive process, often impacted by inter-planner variability and subjective decision-making. To address these challenges, we introduce Dose Optimization Language Agent (DOLA), an autonomous large language model (LLM)-based agent designed for optimizing radiotherapy treatment plans while rigorously protecting patient privacy. DOLA integrates the LLaMa3.1 LLM directly with a commercial treatment planning system, utilizing chain-of-thought prompting, retrieval-augmented generation (RAG), and reinforcement learning (RL). Operating entirely within secure local infrastructure, this agent eliminates external data sharing. We evaluated DOLA using a retrospective cohort of 18 prostate cancer patients prescribed 60 Gy in 20 fractions, comparing model sizes (8 billion vs. 70 billion parameters) and optimization strategies (No-RAG, RAG, and RAG+RL) over 10 planning iterations. The 70B model demonstrated significantly improved performance, achieving approximately 16.4% higher final scores than the 8B model. The RAG approach outperformed the No-RAG baseline by 19.8%, and incorporating RL accelerated convergence, highlighting the synergy of retrieval-based memory and reinforcement learning. Optimal temperature hyperparameter analysis identified 0.4 as providing the best balance between exploration and exploitation. This proof of concept study represents the first successful deployment of locally hosted LLM agents for autonomous optimization of treatment plans within a commercial radiotherapy planning system. By extending human-machine interaction through interpretable natural language reasoning, DOLA offers a scalable and privacy-conscious framework, with significant potential for clinical implementation and workflow improvement.
title Autonomous Radiotherapy Treatment Planning Using DOLA: A Privacy-Preserving, LLM-Based Optimization Agent
topic Medical Physics
Artificial Intelligence
Computation and Language
Emerging Technologies
Human-Computer Interaction
url https://arxiv.org/abs/2503.17553