Use of a synthesized mathematical model to describe the probability of curing early-stage breast cancer
https://doi.org/10.17650/1994-4098-2015-11-2-59-67
Abstract
Breast cancer (ВС) is a common malignant disease of the female reproductive system. Currently we have many treatment strategies given location depending on the clinical data. Radiation therapy is an important component in a comprehensive program of treatment for ВС. Despite the fact that often use a single dose fractionation regime 1.8–2 Gy daily fractions to a total of 50 Gy in 5 weeks, do not run out to try to find new modes of fractionation. According to published research results hypofractionated regimes, we can conclude that the approaches to the value of the dose per fraction,
the number of fractions and the time of treatment differ. Dose per fraction ranged from 2.66 to 3.2 Gy, and more recently have been tested modes with a single dose of 6 Gy. Empirical data from these studies are important, but must also be aware of the possibility of applying mathematical methods for computing the probability of cure of the tumor and the occurrence of radiation complications.
It is necessary for an individual approach to each patient, picking up for some clinical cases the optimal mode of fractionation. In addition, the search continues and improvement fractionation regimes, and the results of clinical trials can tell a lot about how good the chosen model. In work the opportunity of application of the synthesized mathematical model (SM model), intended for description of NTCP, to the description of probability of local treatment of early stages of the ВС.
About the Authors
L. Ya. KlepperRussian Federation
I. A. Gladilina
Russian Federation
V. L. Ushkova
Russian Federation
O. V. Kozlov
Russian Federation
I. V. Vysotskaya
Russian Federation
References
1. Статистика злокачественных новообразований в России и странах СНГ в 2006 году. Под ред. М.И. Давыдова, Е.М. Аксель. Вестник РОНЦ им. Н.Н. Блохина РАМН 2008;19 (2 прил. 1):154. [Statistical data on malignant neoplasms in Russia and CIS countries in 2006. Ed. by M.I. Davydov, E.M. Axel. Vestnik RONC im. N.N. Blokhina RAMN = Bulletin of N.N. Blokhin RСRC, RAMS 2008;19(2 suppl 1):154. (In Russ.)].
2. Гладилина И.А., Монзуль Г.Д., Нечушкин М.И., Курносов А.А. Роль лучевой терапии в программе комплексного лечения больных раком молочной железы. Маммология 2005;(1):31–5. [Gladilina I.A., Monzul G.D., Nechushkin M.I., Kurnosov A.A. Role of radiotherapy in program of combination therapy of the breast cancer patients. Mammologiya = Mammology 2005;(1):31–5. (In Russ.)].
3. Гладилина И.А., Монзуль Г.Д., Ефимкина Ю.В. Современная стратегия лучевой терапии рака молочной железы. Медицинская радиология и радиационная безопасность 2006;(4):71–80. [Gladilina I.A., Monzul G.D., Efimkina Yu.V. Modern strategy of breast cancer radiotherapy. Meditsinskaya radiologiya i radiatsionnaya bezopasnost' = Medical Radiology and Radiation Security 2006;(4):71–80. (In Russ.)].
4. Гладилина И.А. Лучевая терапия. В кн.: Практическая маммология. Под ред. М.И. Давыдова, В.П. Летягина. М.: Практическая медицина, 2007. С. 106–15. [Gladilina I.A. Radiation therapy. In: Practical breast care. Ed. by M.I. Davydov, V.P. Letyagin. Мoscow: Practicheskaya meditsina, 2007. Pp. 106–15. (In Russ.)].
5. Гладилина И.А. Лучевая терапия при раке молочной железы. В кн.: Актуальные аспекты клинической маммологии. Под ред. Е.Б. Камповой-Полевой, С.М. Портного. М.: Авторская Академия, 2014. С. 162–89. [Gladilina I.A. Radiation therapy at breast cancer. In: Actual aspects of clinical mammology. Ed. by E.B. Kampova-Polevaya, S.M. Portnoy. Мoscow: Avtorskaya Akademiya, 2014. Pp. 162–89. (In Russ.)].
6. Brunt A.M., Sydenham M., Bliss J. et al. A 5-fraction regimen of adjuvant radiotherapy for women with early breast cancer: First analysis of the randomized UK FAST trial (ISRCTN62488883, CRUKE/04/015). Eur J Cancer 2009;45(7 Suppl 2).
7. Hall E.J., Giaccia A.J. Radiobiology for the radiologist. Philadelphia: Lippincott Williams&Wilkins, 2006.
8. Gladilina I., Kozlov O., Efimkina U., Nechushkin M. 5-years results of accelerated hypofractionated RT following breast-conserving surgery for breast cancer. Radiother Oncol 2013;106(Suppl 2):S402–3.
9. Chadha M., Woode R., Sillanpaa J. Proceedings of the 51st аnnual ASTRO meeting N162. Int J Radiat Oncol Biol Phys 2009;75(3 Suppl):77.
10. Bentzen B. Bioeffect models of is hypofractionation inaccelerated PBRT. J Eur Soc Radiother Oncol 2012;103
11. Suppl. 1.
12. Beyzadeoglu M. et al. Basic radiation oncology. Springer-Verlag Berlin Heidelberg, 2010. Р. 329–61.
13. Cosset J.M. The come-back of hypofractionation? Cancer Radiother 2005;9 (6–7):366–73.
14. Fowler J.F. 21 years of biologically effective dose. British J Radiol 2010;83(991):554–68.
15. Agrawal R.K., Alhasso A., Barrett-Lee P.J. et al. First results of the randomized UK FAST Trial of radiotherapy hypofractionation for treatment of early breast cancer (CRUKE/04/015). Radiother Oncol 2011;100(1):93–100.
16. Freedman G.M., White J.R., Artur D.W. et al. Accelerated fractionation with a concurrent boost for early stage breast cancer. Radiat Oncol 2013;106:15–20.
17. Harnett A. Fewer fractions of adjuvant external beam radiotherapy for early breast cancer are safe and effective and can now be the standard of care. Why the UK’s NICE accepts fewer fractions as the standard of care for adjuvant radiotherapy in early breast cancer. Breast 2010;19(3):159–62.
18. Hopwood P., Haviland J.S., Sumo G. et al. Comparison of patient-reported breast, arm, and shoulder symptoms and body image after radiotherapy for early breast cancer: 5-year follow- up in the randomized Standardization of Breast Radiotherapy (START) trials. Lancet Oncol 2010;11(3):51–3.
19. Théberge V., Whelan T., Shaitelman S.F., Vicini F.A. Altered fractionation: rationale and justification for whole and partial breast hypofractionated radiotherapy. Semin Radiat Oncol 2011;21(1):55–65.
20. START Trialists' Group; Bentzen S.M., Agrawal R.K., Aird E.G. et al. The UK of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionated for treatment of early breast cancer: randomized trial. Lancet Oncol 2008;9(4):331–41.
21. Whelan T., Pignol J.P., Levine M.N.et al. Long-term results of hypofractionated radiation therapy for breast cancer. N Engl J Med 2010;362(6):513–20.
22. Whelan T.J., Julian J., Wright J. Does loko-regional radiation therapy improve survival in breast cancer? A meta-analysis. J Clin Oncol 2000;18(6):1220–9.
23. Yarnold J., Bentzen S.M., Coles C. Hypofractionated whole-breast radiotherapy for the women with early breast cancer: myths and realities. Int J Radiat Oncol Biol Phys 2011;79(1):1–9.
24. Yarnold J. Hypofractionation. J Eur Soc Radiother Oncol 2012;103Suppl:SP0438.
25. Клеппер Л.Я. Формирование дозовых полей дистанционными источниками излучения. М.: Энергоатомиздат, 1986. 223 c. [Klepper L.Ya. Formation of dose fields by remote radiation sources. Moscow: Energoatomizdat, 1986. 223 p. (In Russ.)]. Клеппер Л.Я. Формирование дозовых полей радиоактивными источниками излучения. М.: Энергоатомиздат, 1993. 273 c. [Klepper L.Ya. Formation of dose fields by radioactive sources. Moscow: Energoatomizdat, 1993. 273 p. (In Russ.)].
26. Клеппер Л.Я. Вероятность возникновения лучевого осложнения в органе или ткани как функция от дозы, объема облучения и схемы фракционирования дозы во времени. Медицинская радиология и радиационная безопасность 1997;42(1):47–50. [Klepper L.Ya. Probability of radiation complication in organ or tissue as function of dose, radiation volume and dose fractionation in time pattern. Meditsinskaya radiologiya i radiatsionnaya bezopasnost' = Medical Radiology and Radiation Security 1997;42(1):47–50. (In Russ.)].
27. Клеппер Л.Я. Синтез радиологических моделей и радиологические инварианты. Часть первая. Медицинская техника 2005;(3):27–32. [Klepper L.Ya. Synthesis of radiologic models and radiologic invariants. Part One. Meditsinskaya tekhnika = Medical Devices 2005;(3):27–32. (In Russ.)].
28. Клеппер Л.Я. Синтез радиологических моделей и радиологические константы. Часть вторая. Медицинская техника 2006;(3):23–7. [Klepper L.Ya. Synthesis of radiologic models and radiologic constants. Part Two. Meditsinskaya tekhnika = Medical Devices 2006;(3):23–7. (In Russ.)].
29. Клеппер Л.Я. Синтез радиологических моделей и радиологические константы. Часть третья. Синтез популяционно-феноменологических моделей и математической модели Клеппера. Медицинская техника 2006;(3):22–6. [Klepper L.Ya. Synthesis of radiologic models and radiologic constants. Part Three. Synthesis of population and phenomenological models and Klepper mathematical model. Meditsinskaya tekhnika = Medical Devices 2006;(3):22–6. (In Russ.)].
30. Клеппер Л.Я. Синтез радиологических моделей и радиологические константы. Часть четвертая. Cинтез популяционно-феноменологических моделей и математической модели Lyman. Медицинская техника 2006;(5):36–40. [Klepper L.Ya. Synthesis of radiologic models and radiologic constants. Part Four. Synthesis of population and phenomenological models and Lyman mathematical model. Meditsinskaya tekhnika = Medical Devices 2006;(5):36–40. (In Russ.)].
31. Клеппер Л.Я. Математические модели для описания вероятности локального излечения плоскоклеточного рака гортани в зависимости от объема опухоли и суммарной дозы. Медицинская физика
32. ;4(44):37–46. [Klepper L.Ya. Mathematical models for description of probability of local recovery of laryngeal epidermoid cancer, depending on the tumor size and total dose. Meditsinskaya fizika = Medical Physics 2009;4(44):37–46. (In Russ.)].
33. Клеппер Л.Я. Синтез модифицированной LQ модели и функции нормального распределения вероятностей для прогнозирования лучевых осложнений в органах и тканях. Медицинская радиология и радиационная безопасность 2011;56(1):43–50. [Klepper L.Ya. Synthesis of modified LQ model and normal probability distribution function for radiation compliacations forecasting both in organs and tissues. Meditsinskaya radiologiya i radiatsionnaya bezopasnost' = Medical Radiology and Radiation Security 2011;56(1):43–50. (In Russ.)].
34. Клеппер Л.Я., Климанов В.А. Определение параметров математических моделей для расчета вероятностей возникновения лучевых осложнений в нормальных органах и тканях организма. Медицинская физика 2002;13(1):23–39. [Klepper L.Ya., Klimanov V.A. Determination of mathematical models parameters for calculation of radiation complications probability in normal organs and tissues of the body. Meditsinskaya fizika = Medical Physics 2002;13(1):23–39. (In Russ.)].
35. Клеппер Л.Я. Синтезированная модель Kehwar–Sharma для планирования лучевой терапии злокачественных опухолей (анализ). Медицинская физика 2014;3(63):13–9. [Klepper L.Ya. Kehwar– Sharma synthesized model for planning of radiation therapy of malignancies (analysis). Meditsinskaya fizika = Medical Physics 2014;3(63):13–9. (In Russ.)].
36. Моисеев Н.Н. Математические задачи системного анализа. М.: Наука, 1981. С. 431. [Moiseev N.N. Mathematical problems of system analysis. Moscow: Nauka, 1981. P. 431. (In Russ.)].
37. Barendsen G.W. Dose fractionation, dose rate and iso-effect relationships for normal tissue response. Int J Radiat Oncol Biol Phys 1982;8(11):1981–97.
38. Chadwick K.H., Leenhouts H.P. A molecular theory of cell survival. Phis Med Biol 1973;1(18):78–87.
39. Kellerer A.M., Rossi H.H. RBE and the primary mechanism of radiation action. Radiat Res 1971;47(1):15–34.
40. Qi X.S., White J., Li X.A. Is α/β for breast cancer really low? Radiother Oncol 2011;100(2):282–8.
Review
For citations:
Klepper L.Ya., Gladilina I.A., Ushkova V.L., Kozlov O.V., Vysotskaya I.V. Use of a synthesized mathematical model to describe the probability of curing early-stage breast cancer. Tumors of female reproductive system. 2015;11(2):59-67. (In Russ.) https://doi.org/10.17650/1994-4098-2015-11-2-59-67