Prioritization of radiotherapy dose fractionation protocols via CPP

This study investigates the feasibility of ranking radiotherapy protocols for breast cancer patients by considering conflicting criteria related to tumor response, tissue preservation, and immune activity. Different dose-fractionation protocols were analyzed through mathematical simulations based on the Pillis and Radunskaya tumor growth model, combined with the linear-quadratic radiobiological model and subsequently evaluated using the probabilistic composition of preferences. The alternatives were compared based on quantitative criteria derived from the numerical simulations. The results indicate that it is possible to establish a consistent ranking among the protocols, highlighting the superior performance of hypofractionated regimens in most scenarios. It is concluded that the integration of mathematical modeling and multicriteria decision support constitutes a promising approach to supporting clinical decision-making.