Watanabe Yoichi, Dahlman Erik L, Leder Kevin Z, Hui Susanta K
Department of Radiation Oncology, University of Minnesota, 420 Delaware St.SE, MMC-494, Minneapolis, MN, 55455, USA.
Industrial and Systems Engineering, University of Minnesota, 111 Church Street SE, Minneapolis, MN, 55455, USA.
Theor Biol Med Model. 2016 Feb 27;13:6. doi: 10.1186/s12976-016-0032-7.
Mathematical modeling of biological processes is widely used to enhance quantitative understanding of bio-medical phenomena. This quantitative knowledge can be applied in both clinical and experimental settings. Recently, many investigators began studying mathematical models of tumor response to radiation therapy. We developed a simple mathematical model to simulate the growth of tumor volume and its response to a single fraction of high dose irradiation. The modelling study may provide clinicians important insights on radiation therapy strategies through identification of biological factors significantly influencing the treatment effectiveness.
We made several key assumptions of the model. Tumor volume is composed of proliferating (or dividing) cancer cells and non-dividing (or dead) cells. Tumor growth rate (or tumor volume doubling time) is proportional to the ratio of the volumes of tumor vasculature and the tumor. The vascular volume grows slower than the tumor by introducing the vascular growth retardation factor, θ. Upon irradiation, the proliferating cells gradually die over a fixed time period after irradiation. Dead cells are cleared away with cell clearance time. The model was applied to simulate pre-treatment growth and post-treatment radiation response of rat rhabdomyosarcoma tumors and metastatic brain tumors of five patients who were treated with Gamma Knife stereotactic radiosurgery (GKSRS).
By selecting appropriate model parameters, we showed the temporal variation of the tumors for both the rat experiment and the clinical GKSRS cases could be easily replicated by the simple model. Additionally, the application of our model to the GKSRS cases showed that the α-value, which is an indicator of radiation sensitivity in the LQ model, and the value of θ could be predictors of the post-treatment volume change.
The proposed model was successful in representing both the animal experimental data and the clinically observed tumor volume changes. We showed that the model can be used to find the potential biological parameters, which may be able to predict the treatment outcome. However, there is a large statistical uncertainty of the result due to the small sample size. Therefore, a future clinical study with a larger number of patients is needed to confirm the finding.
生物过程的数学建模被广泛用于增强对生物医学现象的定量理解。这种定量知识可应用于临床和实验环境。最近,许多研究人员开始研究肿瘤对放射治疗反应的数学模型。我们开发了一个简单的数学模型来模拟肿瘤体积的增长及其对单次高剂量照射的反应。该建模研究可通过识别显著影响治疗效果的生物学因素,为临床医生提供有关放射治疗策略的重要见解。
我们对模型做出了几个关键假设。肿瘤体积由增殖(或分裂)癌细胞和非分裂(或死亡)细胞组成。肿瘤生长速率(或肿瘤体积倍增时间)与肿瘤血管和肿瘤的体积比成正比。通过引入血管生长迟缓因子θ,血管体积的增长比肿瘤慢。照射后,增殖细胞在照射后的固定时间段内逐渐死亡。死亡细胞在细胞清除时间内被清除掉。该模型被应用于模拟大鼠横纹肌肉瘤肿瘤以及接受伽玛刀立体定向放射外科手术(GKSRS)治疗的5例患者的转移性脑肿瘤在治疗前的生长和治疗后的放射反应。
通过选择合适的模型参数,我们表明该简单模型能够轻松复制大鼠实验和临床GKSRS病例中肿瘤的时间变化。此外,我们的模型在GKSRS病例中的应用表明,作为线性二次模型中放射敏感性指标的α值以及θ值可以预测治疗后的体积变化。
所提出的模型成功地呈现了动物实验数据和临床观察到的肿瘤体积变化。我们表明该模型可用于找到潜在的生物学参数,这些参数可能能够预测治疗结果。然而,由于样本量小,结果存在很大的统计不确定性。因此,需要未来进行更多患者的临床研究来证实这一发现。