Sequencing surgery, radiotherapy and chemotherapy: insights from a mathematical analysis
Sequencing surgery, radiotherapy and chemotherapy: insights from a mathematical analysis
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DOI：
10.1023/a:1016357311845
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发表时间：
2002-08-01
影响因子：
3.8
通讯作者：
Wein, LM
中科院分区：
文献类型：
--
作者：
Beil, DR;Wein, LM
我们提出了一个数学分析的结果，旨在找到三种传统癌症治疗方法的最佳顺序：手术（S），化疗（C）和放疗（R）。该数学模型跟踪原发肿瘤及其相关转移瘤的时间演变，并结合原发肿瘤对转移瘤休眠和生长的影响。我们表明，SCR时间表（即，如果原发性肿瘤足够大或者如果转移性群体相对于原发性肿瘤足够大，则外科手术，然后化疗，然后放疗）实现比SRC更高的治愈概率。我们还表明，一种新的时间表，SRCR，分为两个不相交的部分放疗方案，是最佳的所有时间表，只要病人的休眠转移性肿瘤不成为血管化手术后约40天内。
We present results from a mathematical analysis that is aimed at finding the best way to sequence the three traditional cancer treatments: surgery (S), chemotherapy (C), and radiotherapy (R). The mathematical model tracks the temporal evolution of the primary tumor and its associated metastases, and incorporates the primary tumor's effect on the dormancy and growth of the metastases. We show that the SCR schedule (i.e., surgery followed by chemotherapy followed by radiotherapy) achieves a higher cure probability than SRC if the primary tumor is sufficiently large or if the metastatic population is sufficiently large relative to the primary tumor. We also show that a novel schedule, SRCR, which splits the radiotherapy regimen into two disjoint portions, is optimal among all schedules, provided that the patient's dormant metastatic tumors do not become vascularized within about 40 days after surgery.