title: Modeling the Interplay Between Tumor Volume Regression and Oxygenation in Uterine Cervical Cancer During Radiotherapy Treatment.
abstract: This paper describes a patient-specific mathematical model to predict the evolution of uterine cervical tumors at a macroscopic scale, during fractionated external radiotherapy. The model provides estimates of tumor regrowth and dead-cell reabsorption, incorporating the interplay between tumor regression rate and radiosensitivity, as a function of the tumor oxygenation level. Model parameters were estimated by minimizing the difference between predicted and measured tumor volumes, these latter being obtained from a set of 154 serial cone-beam computed tomography scans acquired on 16 patients along the course of the therapy. The model stratified patients according to two different estimated dynamics of dead-cell removal and to the predicted initial value of the tumor oxygenation. The comparison with a simpler model demonstrated an improvement in fitting properties of this approach (fitting error average value <5%, p < 0.01), especially in case of tumor late responses, which can hardly be handled by models entailing a constant radiosensitivity, failing to model changes from initial severe hypoxia to aerobic conditions during the treatment course. The model predictive capabilities suggest the need of clustering patients accounting for cancer cell line, tumor staging, as well as microenvironment conditions (e.g., oxygenation level).
authors: Antonella
authors: A
authors: Belfatto
authors: Marco
authors: M
authors: Riboldi
authors: Delia
authors: D
authors: Ciardo
authors: Federica
authors: F
authors: Cattani
authors: Agnese
authors: A
authors: Cecconi
authors: Roberta
authors: R
authors: Lazzari
authors: Barbara Alicja
authors: BA
authors: Jereczek-Fossa
authors: Roberto
authors: R
authors: Orecchia
authors: Guido
authors: G
authors: Baroni
authors: Pietro
authors: P
authors: Cerveri
mesh_terms: D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008875:Middle Aged; D008954:Models, Biological; D010100:Oxygen / Q000378:metabolism*; D011836:Radiation Tolerance; D016896:Treatment Outcome; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000532:radiotherapy*
chemical_list: D010100:Oxygen