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Recently, clinically validated multivariable normal tissue complication probability models (NTCP) for head and neck cancer (HNC) patients have become available. We test the feasibility of using multivariable NTCP-models directly in the optimiser for inverse treatment planning of radiotherapy to improve the dose distributions and corresponding NTCP-estimates in HNC patients.

For 10 HNC cases, intensity-modulated radiotherapy plans were optimised either using objective functions based on the ‘generalised equivalent uniform dose’ (OF_gEUD) or based on multivariable NTCP-models (OF_NTCP). NTCP-models for patient-rated xerostomia, physician-rated RTOG grade II-IV dysphagia, and various patient-rated aspects of swallowing dysfunction were incorporated. The NTCP-models included dose–volume parameters as well as clinical factors contributing to a …