Abstract
In his presentation at the previous meeting on adjuvant therapy in Tucson, FREI [6] concluded that the effectiveness of adjuvant chemotherapy could very simply be derived from a consideration of four parameters: sensitivity of the tumor to each treatment course, the growth rate of the tumor, the number of treatment courses, and the interval between the courses. He used a formula of the following type: \( \rm{Total}\,\log \,\rm{tumor}\,\rm{cell}\,\rm{kill}\, = \,(\log \,K) \times \,N\frac{\log \,2}{DT}\, - \,(N - 1) \times I \)
in which K is the cell kill per course, N the number of courses, I the interval between them, and DTthe tumor doubling time during regrowth between treatments. Although this formula is undoubtedly valid, its usefulness is limited to a comparison of different treatment intensities to similar tumors. In this sense it was applied to the treatment of osteosarcoma and gave useful insight into the effect of different treatments. In contrast, comparison of the sensitivity of different types of tumors or prediction of response is not feasible since we do not know the parameters K and DT. They are likely to vary from tumor to tumor and since no data are available to help us here, we have considered as a first approximation that these parameters might be similar or proportional for primary tumors and for residual disease. This would imply that the success of adjuvant chemotherapy might be predictable from the results obtained with a similar treatment applied to manifest disease.
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Supported by the Koningin Wilhelmina Fonds, Netherlands Organization for the Fight against Cancer.
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van Putten, L.M., de Ruiter, J., van de Velde, C.J.H., Mulder, J.H., Gerritsen, A.F.C. (1979). Adjuvant Chemotherapy: Theoretical Considerations and Model Studies. In: Bonadonna, G., Mathé, G., Salmon, S.E. (eds) Adjuvant Therapies and Markers of Post-Surgical Minimal Residual Disease I. Recent Results in Cancer Research, vol 67. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-81320-7_18
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