Predicting outcomes in cervical cancer: a kinetic model of tumor regression during radiation therapy

Cancer Res. 2010 Jan 15;70(2):463-70. doi: 10.1158/0008-5472.CAN-09-2501. Epub 2010 Jan 12.

Abstract

Applications of mathematical modeling can improve outcome predictions of cancer therapy. Here we present a kinetic model incorporating effects of radiosensitivity, tumor repopulation, and dead-cell resolving on the analysis of tumor volume regression data of 80 cervical cancer patients (stages 1B2-IVA) who underwent radiation therapy. Regression rates and derived model parameters correlated significantly with clinical outcome (P < 0.001; median follow-up: 6.2 years). The 6-year local tumor control rate was 87% versus 54% using radiosensitivity (2-Gy surviving fraction S(2) < 0.70 vs. S(2) > or = 0.70) as a predictor (P = 0.001) and 89% vs. 57% using dead-cell resolving time (T(1/2) < 22 days versus T(1/2) > or = 22 days, P < 0.001). The 6-year disease-specific survival was 73% versus 41% with S(2) < 0.70 versus S(2) > or = 0.70 (P = 0.025), and 87% vs. 52% with T(1/2) < 22 days versus T(1/2) > or = 22 days (P = 0.002). Our approach illustrates the promise of volume-based tumor response modeling to improve early outcome predictions that can be used to enable personalized adaptive therapy.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Models, Biological*
  • Multivariate Analysis
  • Neoplasm Staging
  • Prognosis
  • Treatment Outcome
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / radiotherapy*