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20 September 2019rnCurrently, several commercial treatment planning systems (TPS) including Eclipse, Pinnacle, Monaco, and Raystation can perform accurate dose optimization and calculations in radiation therapy of various cancers. However, most of the TPSs only use the dose-volume (DV)-based physical functions when optimizing the inverse intensity modulated radiotherapy (IMRT) treatment plans. The main drawback of this optimization is that it does not represent the nonlinear response of the tumor