转移性肿瘤治疗中最大耐受剂量与节律方案的比较
Maximum Tolerated Dose Versus Metronomic Scheduling in the Treatment of Metastatic Cancers
摘要：
虽然最优控制理论已被用于抗癌药物调度优化的理论研究，但以减小原发肿瘤体积为目的，往往忽略了对转移瘤的影响。在这里，我们使用先前发表的转移发展模型来定义一个最佳控制问题的患者的整个有机体的规模。对抗血管生成和细胞毒性药物（单药治疗或联合治疗）的不同给药方案的影响进行了计算机模拟研究，以比较低剂量、连续、节拍给药方案与更经典的最大耐受剂量给药方案。模拟结果揭示了原发性肿瘤减少和转移控制之间的差异，但总体上建议使用节拍协议。
英文摘要：
Although optimal control theory has been used for the theoretical study of anti-cancerous drugs scheduling optimization, with the aim of reducing the primary tumor volume, the effect on metastases is often ignored. Here, we use a previously published model for metastatic development to define an optimal control problem at the scale of the entire organism of the patient. In silico study of the impact of different scheduling strategies for anti-angiogenic and cytotoxic agents (either in monotherapy or in combination) is performed to compare a low-dose, continuous, metronomic administration scheme with a more classical maximum tolerated dose schedule. Simulation results reveal differences between primary tumor reduction and control of metastases but overall suggest use of the metronomic protocol.
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