Dr. Eva K. Lee, associate professor in the H. Milton Stewart School of Industrial and Systems Engineering, in conjunction with Memorial Sloan-Kettering Cancer Center (MSKCC) won the prestigious 2007 Franz Edelman Award for work entitled "Operations Research Advances Cancer Therapeutics.* The award was announced at the annual INFORMS conference on Operations Research Practice in Vancouver on April 30, 2007.

"Eva, in conjunction with Memorial Sloan-Kettering Cancer Center , has made an extraordinary difference in the health and well-being of cancer patients,* Chip White said. "I couldn't be more proud of the work they are doing to help extend access to quality health care for more Americans.*

Working with Dr. Marco Zaider, head of Brachytherapy Physics at Memorial Sloan-Kettering Cancer Center (MSKCC), Lee 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 of cancer.

Lee's optimization models and algorithms guide doctors toward the most effective dose provided by each radioactive seed, the shape of the organ being treated, the locations of tumor cells within the organ and critical structures for which radiation dose should be limited, the sensitivity of tissues to radiation, and the expected shrinkage of the organ after treatment. The system's goal is to provide consistent tumor-killing radiation doses to the tumor cells while limiting potentially damaging doses to nearby critical structures.

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, Lee estimates conservatively that their elimination nationwide could save on the order of $450 million a year for prostate cancer care alone. Effectively, this work improves the survival rate of patients with prostate cancer, reduces the side effects of treatment, and reduces costs to the health care system.

As reported in a recent article by Dr. Michael Zelefsky and his colleagues at MSKCC "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.

The system is licensed to a medical software company, and its distribution 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 clinicians can make adjustments (and re-optimize) on-the-fly during operations to arrive at the best-possible plan.

The planning system is also an important training tool for inexperienced clinicians and residents to develop effective and safe treatment plans.

Besides prostate, Lee has also been working with medical specialists on advancing treatments for breast, lung, cervical, brain and liver cancers, as well as early diagnosis and prediction of disease for proper intervention.

Each year, the Franz Edelman competition recognizes outstanding examples of operations research (O.R.) 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.

This year's Franz Edelman finalists included Coca-Cola, The U.S. Coast Guard, Hewlett-Packard and Daimler-Chrysler. Past winners of the award include Motorola, Merrill Lynch, Canadian Pacific Railway and IBM.

This is the first time that INFORMS has awarded the Edelman prize for a medical treatment. Further, the 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.