Gompertzian tumor growth

The study of tumor growth forms the foundation for many of the basic principles of modem cancer chemotherapy. The growth of most tumors is illustrated by the Gompertzian tumor growth curve (Fig. 124-5). Gompertz was a German insurance actuary who described the relationship between age and expected death. This mathematical model also approximates tumor-cell proliferation. In the... 

FIGURE 124-5. Gompertzian kinetics tumor-growth curve relationship to symptoms, diagnosis, and various treatment regimens. (Reproduced with permission from BuickJ" )... 

Under certain conditions, the Gompertzian tumor model provides an accurate barometer for tumor growth in vivo. However, deviations occur over time due to selection and expansion sub-clones that are chemo-resistant. Skipper s Cell Kill Hypothesis is based on the notion that chemotherapy will lead first-order cell kill kinetics. Therefore, each administration of chemotherapy will produce tiie same fraction of tumor cell death. In theory, it is believed that a log-cell drop of 9 to 11 orders of magnitude is required for tumor eradication. Clinically this scenario is complicated by the chemosen-sitivity of normal tissue and tumor, pharmacokinetic hetereogeneity of patients, and tumor heterogeneity. 

FIGURE 85-2. The Gompertzian growth curve demonstrating symptoms and treatments versus tumor volume. (From Buick RN. Cellular basis of chemotherapy. In Dorr RT, Von Hoff DD, (eds.) Cancer Chemotherapy Handbook. 2nd ed. New York Elsevier 1994 3-14.)... 

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