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Hindawi Publishing Corporation Computational and Mathematical Methods in Medicine Volume 2012, Article ID 348471, 7 pages doi:10.1155/2012/348471 Research Article Risk-Adaptive Volumetric Modulated Arc Therapy Using Biological Objective Functions for Subvolume Boosting in Radiotherapy Nicholas Hardcastle1, 2, 3 and Wolfgang A. Tome1, 3, 4 1 Departments of Human Oncology and Medical Physics, University of Wisconsin-Madison, Madison, WI 53792, USA 2 Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne, VIC 3002, Australia 3 Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, Australia 4 Oncophysics Institute, Albert Einstein College of Medicine of Yeshiva University, Jack and Pearl Resnick Campus, 1300 Morris Park Avenue, Bronx, NY 10461, USA Correspondence should be addressed to Wolfgang A. Tome, tome@ Received 19 March 2012; Accepted 26 April 2012 Academic Editor: Scott Penfold Copyright © 2012 N. Hardcastle and W. A. Tome. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives. Simultaneous integrated boost (SIB) for prostate cancer allows increases in tumor control probability while respecting normal tissue dose constraints. Biological optimization functions that optimize based on treatment outcome can be used to create SIB prostate plans. This study investigates the feasibility of biologically optimized volumetric modulated arc therapy (VMAT) for SIB prostate radiotherapy. Methods. Five prostate cancer patients with diffusion-weighted MR images were selected for analysis. A two-step VMAT optimization was per