Fig. 7.

Optimal patient-specific radiation doses to induce favorable TIES shifts. (A) Proof-of-principle simulation of radiation-induced shifts in the TIES composition. Big circles mark the TIES composition prior to radiation, smaller circles mark TIES composition after each radiation fraction (2 Gy x 10). After radiation, tumor-immune dynamics are simulated until the tumor either becomes extinct (green trajectories) or regrows to pretreatment size (red trajectories). (B) Model-predicted locoregional control (LRC, green) or locoregional failure (LRF, red) for the patient-specific radiation dose, RSI, and initial TIES composition for 59 NSCLC patients. (C) Model predictions of locoregional control (LRC, green) or locoregional failure (LRF, red) for 59 NSCLC patients. Percentages denote prediction accuracy for each quadrant of RSI^lo/hi and iRIS^lo/hi. (D) Model-derived minimum required number of radiation fractions to control individual patient tumors with their respective RSI, iRIS, and delivered dose per fraction (1.8 Gy/fx, circles; 2 Gy/fx, squares). (E) Model-derived difference in clinically prescribed number of fractions and model-derived minimum required number of radiation fractions to control individual patient tumors. (F) Simulated shifts in TIES composition of 3 individual patients marked in panel E. (G–I). Population dynamics for the 3 individual patients marked in panels E and F. Gray shaded background denotes times of radiation therapy.