When is better best? A multiobjective perspective.

PURPOSE To identify the most informative methods for reporting results of treatment planning comparisons. METHODS Seven articles from the past year of International Journal of Radiation Oncology Biology Physics reported on comparisons of treatment plans for IMRT and IMAT. The articles were reviewed to identify methods of comparisons. Decision theoretical concepts were used to evaluate the study methods and highlight those that provide the most information. RESULTS None of the studies examined the correlation between objectives. Statistical comparisons provided some information but not enough to provide support for a robust decision analysis. CONCLUSIONS The increased use of treatment planning studies to evaluate different methods in radiation therapy requires improved standards for designing the studies and reporting the results.