Prediction of Treatment Response for Combined Chemo- and Radiation Therapy for Non-Small Cell Lung Cancer Patients Using a Bio-Mathematical Model. Issue 1 (December 2017)

• Record Type: Journal Article
• Authors: Geng, Changran; Paganetti, Harald; Grassberger, Clemens
• Is Part Of: Scientific reports. Volume 7:Issue 1(2017)
• Page Start: 1
• Page End: 12
• Publication Date: 2017-12
• Subjects: Natural history -- Research -- Periodicals; Biology -- Research -- Periodicals; Physical sciences -- Research -- Periodicals; Earth sciences -- Research -- Periodicals; Environmental sciences -- Research -- Periodicals; 502.85
• DOI: 10.1038/s41598-017-13646-z
• Languages: English
• ISSNs: 2045-2322

Abstract

Abstract The goal of this work was to develop a mathematical model to predict Kaplan–Meier survival curves for chemotherapy combined with radiation in Non-Small Cell Lung Cancer patients for use in clinical trial design. The Gompertz model was used to describe tumor growth, radiation effect was simulated by the linear-quadratic model with anα /β -ratio of 10, and chemotherapy effect was based on the log-cell kill model. To account for repopulation during treatment, we considered two independent methods: 1) kickoff-repopulation using exponential growth with a decreased volume doubling time, or 2) Gompertz-repopulation using the gradually accelerating growth rate with tumor shrinkage. The input parameters were independently estimated by fitting to the SEER database for untreated tumors, RTOG-8808 for radiation only, and RTOG-9410 for sequential chemo-radiation. Applying the model, the benefit from concurrent chemo-radiation comparing to sequential for stage III patients was predicted to be a 6.6% and 6.2% improvement in overall survival for 3 and 5-years respectively, comparing well to the 5.3% and 4.5% observed in RTOG-9410. In summary, a mathematical model was developed to model tumor growth over extended periods of time, and can be used for the optimization of combined chemo-radiation scheduling and sequencing.