New prostate cancer treatment wins award for Sloan-Kettering

The unique application of operations research to the treatment of prostate cancer allowed Memorial Sloan-Kettering Cancer Center to better Fortune 500 companies and win an international competition for best project by an organization.

Sloan-Kettering won the Franz Edelman Award for Achievement in Operations Research for work entitled “Operations Research Answers to Cancer Therapeutics.” The work improves the survival rate of patients with prostate cancer, reduces the side effects of treatment, and reduces costs to the health care system.

Yesterday was the first time that the association awarded the Edelman prize for a medical treatment. The Sloan-Kettering win demonstrates how operations research and mathematics are increasingly bringing improvements to health care, not only in the areas of policy, finance, and public health but in diagnosis and treatment, as well.

Dr. Marco Zaider, Attending Physicist in Medical Physics at Memorial Sloan-Kettering Cancer Center received the award together with Professor Eva K. Lee, Director of the Center for Operations Research in Medicine and HealthCare in the School of Industrial and Systems Engineering at Georgia Institute of Technology.

The 2007 Franz Edelman Award winner was announced at a special awards banquet during The Institute for Operations Research and the Management Sciences (INFORMS) Conference on O.R. Practice in Vancouver. The finalists included Coca-Cola Enterprises, Hewlett-Packard, DaimlerChrysler, and the U.S. Coast Guard.

Dr. Lee and Dr. Zaider devised sophisticated optimization modeling and computational techniques to implement an intra-operative 3D treatment planning system for brachytherapy (the placement of radioactive “seeds” inside a tumor) that offers a safer and more reliable treatment.

The real-time intra-operative planning system eliminates pre-operation simulation and post-implant imaging analysis. Based on the range of costs of these procedures, Prof. Lee estimated conservatively that their elimination nationwide could save $450 million a year for prostate cancer care alone.

As reported in a recent article by Dr. Michael Zelefsky and his colleagues at Sloan-Kettering, “real-time intraoperative planning consistently achieved optimal coverage of the prostate with the prescription dose with concomitant low doses delivered to the urethra and rectum. Biochemical control outcomes were excellent at 5 years and late toxicity was unusual. These data demonstrate that real-time planning methods can consistently and reliably deliver the intended dose distribution to achieve an optimal therapeutic ratio between the target and normal tissue structures.”

Resulting reduction of complications (45-60%) due to plans that deliver less radiation to healthy structures improves the quality-of-life for patients, and has a profound impact on the cost for interventions to manage side-effects. Drs. Lee and Zaider also reported that the procedure uses significantly fewer seeds and needles compared to current best-practice procedures. Thus the procedure time is shortened and less invasive, and there is less blood loss. As a result, patients experience less pain and recover faster.

National distribution of this system will allow achievement of consistent treatment planning across different clinics, thus reducing the variability in the quality of treatment plans. The resulting plans limit urethral dose, decrease the operator-dependency, and reduce the influence of the learning curve associated with prostate brachytherapy. These all have important consequences for the outcome of treated patients. The system allows for dynamic dose correction, thus helping the training of clinicians and residents to develop effective and safe treatment plans.

The procedure is also being used to treat breast cancer.

Every year, the Franz Edelman competition recognizes outstanding examples of Operations Research (O.R.)-based projects that have transformed companies, entire industries, and people's lives. O.R. uses advanced analytical methods to help make better decisions and is a disciplined way by which management can improve organizational performance in a wide variety of situations, in nearly any type of organization in the public or private sector.