Models for dose intensity

From MaRDI portal





The authors introduce a concept of a time-dependent dose intensity function as a determinant of the therapeutic outcome of chemotherapy in cancer treatment related to tumor size, generalizing a proposal by Hryniak [\textit{W. M. Hryniak} and \textit{M. Bush}, The importance of dose intensity in the chemotherapy of metastatic breast cancer J. Clin. Oncol. 2, 1281-1288 (1984)]. The number N(t) of tumor cells at time t is modelled as \[ d(\ln N(t))/dt=h_ 1(N(t))[1-h_ 2(C(t)] \] where \(h_ 1\) and \(h_ 2\) are integrable functions referred to growth and kill, and where c(t) is the drug concentration at time t; \(N(0)=1\), \(h_ 1(N)>0\), and \(h_ 2(0)=0\). The dose intensity for the interval (t',t) is defined as \[ I(t',t)=[\int^{t}_{t'}h_ 2(C(u))du]/(t-t') \] represnting a mean kill over that interval. The possible range of application is discussed and illustrated by two examples where \(h_ 2=k C\). For chemotherapy administred as a series of cycles repeated a fixed number of times at regular intervals, a ranking of protocols by their dose intensity function is defined and the case \(h_ 2(C(t))=k C(t)\) is considered. The model is finally extended to the development of drug resistance by introducing the probability \(P_ 0(t)\) that there are no resistant cells at time t as solution of \[ d(\ln P_ 0(t))/dt=-\alpha h_ 1(N(t))N(t). \] Calculation of the conditional probability \(P(t',t)=P_ 0(t)/P_ 0(t')\) that resistance develops for the first time in the inteval [t',t] shows that protocols can then no longer be ranked by the dose intensity alone but have to be complemented by information from the tumor's growth.











This page was built for publication: Models for dose intensity

Report a bug (only for logged in users!)Click here to report a bug for this page (MaRDI item Q1117155)