Document Detail


Sequencing surgery, radiotherapy and chemotherapy: insights from a mathematical analysis.
MedLine Citation:
PMID:  12206517     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Damian R Beil; Lawrence M Wein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Breast cancer research and treatment     Volume:  74     ISSN:  0167-6806     ISO Abbreviation:  Breast Cancer Res. Treat.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-09-02     Completed Date:  2003-01-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8111104     Medline TA:  Breast Cancer Res Treat     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  279-86     Citation Subset:  IM    
Affiliation:
Operations Research Center, Massachusetts Institute of Technology, Cambridge 02139, USA.
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MeSH Terms
Descriptor/Qualifier:
Breast Neoplasms / drug therapy,  radiotherapy,  surgery,  therapy*
Decision Support Techniques*
Female
Humans
Mathematics

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