A computer-implemented method for radiation therapy treatment plan optimization based upon analysis of trade-offs between competing radiation therapy treatment plan objectives, wherein objectives relate to radiation therapy treatment plan goals, said method comprising: loading a patient record including medical images into a treatment planning tool set; scanning a knowledge base for treatment types used by previous patient records with similar metadata, wherein the knowledge base includes previous treatment plans; selecting and downloading a selected treatment type of the treatment types into the treatment planning tool set; segmenting and contouring structures of interest in medical images of the patient record; generating a three-dimensional dose distribution map using the selected treatment type; optimizing the three-dimensional dose distribution map; generating a first radiation therapy treatment plan using the selected treatment type with the treatment planning tool set; identifying a selection of metrics of the first radiation therapy treatment plan, wherein a metric of a radiation therapy treatment plan relates to how well the radiation therapy treatment plan performs in relation to an objective, determining a percentile score for each of the metrics of the selection of metrics, said percentile scores defining how well the first radiation therapy treatment plan compares to previous treatment plans selected from the knowledge base; identifying at least one parameter associated with a first objective of the first radiation treatment plan that affects an identified metric of the selection of metrics; comparing the at least one parameter for the first objective to at least one parameter for a competing objective, identifying a possible trade-off that will improve the identified metric, wherein said trade-off is between competing objectives such that changing the at least one parameter of the first objective to improve the identified metric is at the expense of said competing objective; and determining at least one alternative treatment step for the first radiation therapy treatment plan that will change the at least one parameter for the first objective to improve the percentile score of the identified metric at the expense of the competing objective. loading a patient record including medical images into a treatment planning tool set; scanning a knowledge base for treatment types used by previous patient records with similar metadata, wherein the knowledge base includes previous treatment plans; selecting and downloading a selected treatment type of the treatment types into the treatment planning tool set; segmenting and contouring structures of interest in medical images of the patient record; generating a three-dimensional dose distribution map using the selected treatment type; optimizing the three-dimensional dose distribution map; generating a first radiation therapy treatment plan using the selected treatment type with the treatment planning tool set; identifying a selection of metrics of the first radiation therapy treatment plan, wherein a metric of a radiation therapy treatment plan relates to how well the radiation therapy treatment plan performs in relation to an objective, determining a percentile score for each of the metrics of the selection of metrics, said percentile scores defining how well the first radiation therapy treatment plan compares to previous treatment plans selected from the knowledge base; identifying at least one parameter associated with a first objective of the first radiation treatment plan that affects an identified metric of the selection of metrics; comparing the at least one parameter for the first objective to at least one parameter for a competing objective, identifying a possible trade-off that will improve the identified metric, wherein said trade-off is between competing objectives such that changing the at least one parameter of the first objective to improve the identified metric is at the expense of said competing objective; and determining at least one alternative treatment step for the first radiation therapy treatment plan that will change the at least one parameter for the first objective to improve the percentile score of the identified metric at the expense of the competing objective.