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In the traditional therapy of cancers, surgery is a main method but it often fails to cure patients for complex reasons. Thus, a new therapeutic approach including both surgery and immunotherapy has been proposed and shown to be effective clinically in inhibiting cancer cells while retaining immunologic memory. This comprehensive strategy guided by a threshold of tumour cells in an immune tumour system is modelled and conditions for successful control of tumours and related dynamics are addressed. A mathematical model with state-dependent impulsive interventions is formulated to describe surgery combined with immunotherapy. By analyzing the properties of the Poincaré map we examine the global dynamics of the immune tumour system with state-dependent feedback control, including the existence and stability of the semi-trivial order-1 periodic solution and the positive order-k periodic solution. The main results showed that surgery alone can only control the tumour size below a certain level while there is no immunologic memory. If comprehensive therapy involving combining surgery with immunotherapy is considered, then not only can the cancers be controlled below a certain level, but the immune system can also retain its activity. The existence of positive order-k periodic solutions implies that periodical therapy is needed to control the cancers, however choosing the treatment frequency and the strength of the therapy remains challenging, and hence a strategy of individual-based therapy is suggested.
In the traditional therapy of cancers, surgery is a main method but it often fails to cure patients for complex reasons. Thus, a new therapeutic approach including both surgery and immunotherapy has been proposed and shown to be effective clinically in inhibiting cancer cells while retaining immunologic memory. This comprehensive strategy guided by a threshold of tumour cells in an immune tumour system is modelled and conditions for successful control of tumours and related dynamics are addressed. A mathematical model with state-dependent impulsive interventions is formulated to describe surgery combined with immunotherapy. By analyzing the properties of the Poincaré map we examine the global dynamics of the immune tumour system with state-dependent feedback control, including the existence and stability of the semi-trivial order-1 periodic solution and the positive order-k periodic solution. The main results showed that surgery alone can only control the tumour size below a certain level while there is no immunologic memory. If comprehensive therapy involving combining surgery with immunotherapy is considered, then not only can the cancers be controlled below a certain level, but the immune system can also retain its activity. The existence of positive order-k periodic solutions implies that periodical therapy is needed to control the cancers, however choosing the treatment frequency and the strength of the therapy remains challenging, and hence a strategy of individual-based therapy is suggested.
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