Breast Cancer Research and Treatment

, Volume 74, Issue 3, pp 279–286 | Cite as

Sequencing Surgery, Radiotherapy and Chemotherapy: Insights from a Mathematical Analysis

  • Damian R. Beil
  • Lawrence M. Wein


We present results from a mathematical analysis that is aimed at finding the best way to sequence the three traditional cancer treatments: surgery (S), chemotherapy (C), and radiotherapy (R). The mathematical model tracks the temporal evolution of the primary tumor and its associated metastases, and incorporates the primary tumor's effect on the dormancy and growth of the metastases. We show that the SCR schedule (i.e., surgery followed by chemotherapy followed by radiotherapy) achieves a higher cure probability than SRC if the primary tumor is sufficiently large or if the metastatic population is sufficiently large relative to the primary tumor. We also show that a novel schedule, SRCR, which splits the radiotherapy regimen into two disjoint portions, is optimal among all schedules, provided that the patient's dormant metastatic tumors do not become vascularized within about 40 days after surgery.

chemotherapy mathematical analysis primary tumor radiotherapy surgery 


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Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  • Damian R. Beil
    • 1
  • Lawrence M. Wein
    • 2
  1. 1.Operations Research CenterMassachusetts Institute of TechnologyCambridgeUSA
  2. 2.Sloan School of ManagementMassachusetts Institute of TechnologyCambridgeUSA

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