A prescription‐free, radiobiology‐based framework for automated VMAT planning: A feasibility study in primary prostate cancer radiotherapy

This study demonstrated the feasibility of a fully automated, prescription-free VMAT planning framework for primary prostate cancer, indicating its potential for future clinical implementation. The proposed framework directly optimized treatment plans in radiobiological objective space, producing Pareto-optimal, clinically deliverable solutions using predefined TCP and NTCP levels. It enables patient-specific trade-off analysis taking into account tumor control and normal tissue complication risk. The work provides a foundation for further development, including the incorporation of geometric uncertainties, acceleration through parallel or GPU-based computation, and application to additional tumor sites.