A prediction-based approach for online dynamic radiotherapy scheduling

Patient scheduling is a difficult task as it involves dealing with stochastic factors such as an unknown arrival flow of patients. Scheduling radiotherapy treatments for cancer patients faces a similar problem. Curative patients need to start their treatment within the recommended deadlines, i.e., 14 or 28 days after their admission while reserving treatment capacity for palliative patients who require urgent treatments within 1 to 3 days after their admission. Most cancer centers solve the problem by reserving a fixed number of treatment slots for emergency patients. However, this flat-reservation approach is not ideal and can cause overdue treatments for emergency patients on some days while not fully exploiting treatment capacity on some other days, which also leads to delaying treatment for curative patients. This problem is especially severe in large and crowded hospitals. In this paper, we propose a prediction-based approach for online dynamic radiotherapy scheduling. An offline problem where all future patient arrivals are known in advance is solved to optimality using Integer Programming. A regression model is then trained to recognize the links between patients' arrival patterns and their ideal waiting time. The trained regression model is then embedded in a prediction-based approach that schedules a patient based on their characteristics and the present state of the calendar. The numerical results show that our prediction-based approach efficiently prevents overdue treatments for emergency patients while maintaining a good waiting time compared to other scheduling approaches based on a flat-reservation policy.