Computational fluid dynamics study of intra-arterial chemotherapy for oral cancer

Abstract

Background: Intra-arterial chemotherapy (IAC) for oral cancer can deliver a higher concentration of anticancer agent into a tumor-feeding artery than intravenous systemic chemotherapy. However, distribution of anticancer agent into several branches of the external carotid artery (ECA) in IAC has not demonstrated sufficient treatment efficacy. To improve the effectiveness of IAC, the flow distribution of anticancer agent into the branches of the ECA in several IAC methods was investigated using computational fluid dynamics (CFD).Methods: Patient-specific three-dimensional vessel models were created from CT images of 2 patients with tongue cancer. Catheter models were combined with the vessel models. Thirty-two models were generated with varying vertical and horizontal positions of the catheter tip. With the use of a zero-dimensional resistance model of the peripheral vessel network, conventional IAC and superselective IAC were simulated in 30 and 2 models, respectively. The flow distribution of anticancer agent into the branches of the ECA was investigated in 32 models. Additionally, the blood streamline was traced from the inlet of the common carotid artery toward each outlet to examine the flow of anticancer agent in all models, and the wall shear stress of the vessel was calculated for some models. Results:The CFD simulations could be conducted within a reasonable computational time. In several models, the anticancer agent flowed into the target artery only when the catheter tip was located below the bifurcation of the ECA and each target artery.

Efficacy and Safety of Intro-Arterial Chemotherapy Combined with Radiotherapy on Head and Neck Cancer: A Systematic Review and Meta-Analysis

“…Other studies reported that mucositis and dysphagia were regarded to be inevitable but reversible 14, 32. Additionally, systemic toxicities such as anemia, thrombocytopenia and leukopenia were also reported before 60-62. Here, we summarized ten toxicities from the 34 studies, including oral diseases, mucositis, leukopenia, dermatitis, anemia, general condition, thrombocytopenia, nausea/vomiting, fever and hepatic dysfunction.…”

Computational Fluid Dynamics Study of Superselective Intra-arterial Chemotherapy for Oral Cancer: Flow Simulation of Anticancer Agent in the Linguofacial Trunk

“…This computational fluid dynamics study was performed based on our previous studies [13,14], and was approved by the Ethics Committee of Yokohama City University (No. B200600075).…”

“…where ρ i is the density of the species i. ρ 0 (density of agent) and ρ 1 (density of blood) were set as 1050.0 and 998.2 m 3 /kg [13], respectively. In the 3D region, the viscosity of the mixture was defined using mass-weighted-mixing law as follows:…”

“…where µ m is the viscosity of the mixture and µ i is the viscosity of species i. µ 0 (viscosity of agent) and µ 1 (viscosity of blood) were set as 0.0010 and 0.0046 Pa s, respectively [13]. In the 0D resistance model, the viscosity of blood (µ 1 ) was defined as the function of the diameter of the vessel detailed in [13,14].…”

“…Therefore, we have been using computational fluid dynamics (CFD) to elucidate the mechanism of anticancer agent distribution in IAC, because CFD has been widely used to investigate physical variables in the fluid phenomenon that cannot be reproduced experimentally. Our previous study demonstrated that the mass distribution of the anticancer agent in IAC is dominated by blood flow field and the flow of the agent into the targeted tumor-feeding artery is determined whether the blood flow that comes from the inlet of the CCA toward the artery contacts the catheter tip or not [13]. In the situations, the anticancer agent flow in the linguofacial trunk is thought to be dominated by the blood flow field in the common trunk.…”