Abstract
The majority of cancer-related fatalities are due to metastatic disease. Chemotherapeutic agents are administered along with radiation in chemoradiotherapy (CRT) to control the primary tumor and systemic disease such as metastasis. This work introduces a mathematical model of CRT treatment scheduling to obtain optimal drug and radiation protocols with the objective of minimizing metastatic cancer cell populations at multiple potential sites while maintaining a desired level of control on the primary tumor. Dynamic programming framework is used to determine the optimal radiotherapy fractionation regimen and the drug administration schedule. We design efficient DP data structures and use structural properties of the optimal solution to reduce the complexity of the resulting DP algorithm. We derive closed-form expressions for optimal chemotherapy schedules in special cases. The results suggest that if there is only an additive and spatial cooperation between the chemotherapeutic drug and radiation with no in...
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