Mathematical model of 5-[125I]Iodo-2'-deoxyuridine treatment: Continuous infusion regimens for hepatic metastases

George Sgouros, Joseph A. O'Donoghue, Steven M. Larson, Homer MacApinlac, Justine Julia Larson, Nancy Kemeny

Research output: Contribution to journalArticle

Abstract

Purpose: Due to the cytotoxicity of DNA-bound iodine-125, 5- [125I]Iodo-2'-deoxyuridine ([125I]IUdR), an analog oF thymidine, has long been recognized as possessing therapeutic potential. In this work, the feasibility and potential effectiveness of hepatic artery infusion of [125I]IUdR is examined. Methods: A mathematical model has been developed that simulates tumor growth and response to [125I]IUdR treatment. The model is used to examine the efficacy and potential toxicity of prolonged infusion therapy. Treatment of kinetically homogeneous tumors with potential doubling times of either 4, 5, or 6 days is simulated. Assuming uniformly distributed activity, absorbed dose estimates to the red marrow, liver and whole-body are calculated to assess the potential toxicity of treatment. Results: Nine to 10 logs of tumor-cell kill over a 7- to 20-day period are predicted by the various simulations examined. The most slowly proliferating tumor was also the most difficult to eradicate. During the infusion time, tumor-cell loss consisted of two components: A plateau phase, beginning at the start of infusion and ending once the infusion time exceeded the potential doubling time of the tumor; and a rapid cell-reduction phase that was close to log-linear. Beyond the plateau phase, treatment efficacy was highly sensitive to tumor activity concentration. Conclusions: Model predictions suggest that [125I]IUdR will be highly dependent upon the potential doubling time of the tumor. Significant tumor cell kill will require infusion durations that exceed the longest potential doubling time in the tumor-cell population.

Original languageEnglish (US)
Pages (from-to)1177-1183
Number of pages7
JournalInternational Journal of Radiation Oncology, Biology, Physics
Volume41
Issue number5
DOIs
StatePublished - Jul 15 1998
Externally publishedYes

Fingerprint

Idoxuridine
metastasis
mathematical models
Theoretical Models
tumors
Neoplasm Metastasis
Liver
Neoplasms
toxicity
plateaus
cells
iodine 125
thymidine
Hepatic Artery
arteries
liver
Iodine
Thymidine
therapy
deoxyribonucleic acid

Keywords

  • Iodine
  • Hepatic artery infusion
  • Iododeoxyuridine
  • Modeling
  • Treatment planning

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Mathematical model of 5-[125I]Iodo-2'-deoxyuridine treatment : Continuous infusion regimens for hepatic metastases. / Sgouros, George; O'Donoghue, Joseph A.; Larson, Steven M.; MacApinlac, Homer; Larson, Justine Julia; Kemeny, Nancy.

In: International Journal of Radiation Oncology, Biology, Physics, Vol. 41, No. 5, 15.07.1998, p. 1177-1183.

Research output: Contribution to journalArticle

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abstract = "Purpose: Due to the cytotoxicity of DNA-bound iodine-125, 5- [125I]Iodo-2'-deoxyuridine ([125I]IUdR), an analog oF thymidine, has long been recognized as possessing therapeutic potential. In this work, the feasibility and potential effectiveness of hepatic artery infusion of [125I]IUdR is examined. Methods: A mathematical model has been developed that simulates tumor growth and response to [125I]IUdR treatment. The model is used to examine the efficacy and potential toxicity of prolonged infusion therapy. Treatment of kinetically homogeneous tumors with potential doubling times of either 4, 5, or 6 days is simulated. Assuming uniformly distributed activity, absorbed dose estimates to the red marrow, liver and whole-body are calculated to assess the potential toxicity of treatment. Results: Nine to 10 logs of tumor-cell kill over a 7- to 20-day period are predicted by the various simulations examined. The most slowly proliferating tumor was also the most difficult to eradicate. During the infusion time, tumor-cell loss consisted of two components: A plateau phase, beginning at the start of infusion and ending once the infusion time exceeded the potential doubling time of the tumor; and a rapid cell-reduction phase that was close to log-linear. Beyond the plateau phase, treatment efficacy was highly sensitive to tumor activity concentration. Conclusions: Model predictions suggest that [125I]IUdR will be highly dependent upon the potential doubling time of the tumor. Significant tumor cell kill will require infusion durations that exceed the longest potential doubling time in the tumor-cell population.",
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