by Caleb Sooknanan ’20
Surgical procedures have often been used to treat oral cancer. However, these procedures can cause oral dysfunction — often in the form of speech and breathing difficulties — and thereby harm respiratory organs. To preserve organ function, intra-arterial chemotherapy (IAC) has become a valuable form of treatment. IAC releases more anticancer agents into tumor-feeding arteries than intravenous systemic chemotherapy. However, anticancer agents — when dispersed into the branches of the external carotid artery (ECA) during IAC — do not always elicit the desired results. Dr. Hiroaki Kitajima and researchers at the Yokohama City University Graduate School of Medicine in Japan conducted a study to improve the effectiveness of IAC; the researchers utilized computational fluid dynamics (CFD) to analyze the flow distribution of anticancer agent into the branches of the ECA during IAC procedures.
To conduct this study, the researchers obtained computerized tomography (CT) scans of two tongue cancer patients to create three-dimensional vessel models and integrate them with specific catheter models. 32 models were generated with various positions of the catheter tip, with IAC being simulated in part due to zero-dimensional resistance models of the peripheral vessel network. Using these models, the researchers analyzed the flow distribution of anticancer agents into the ECA’s branches. Additionally, blood streamlines were traced from the inlet of the common carotid artery to each outlet to examine the flow of anticancer agents within each model.
The researchers found that for several models, the anticancer agents flowed into the target artery when the catheter tip was shifted toward the target artery. In all ECA branches with flow of anticancer agent, the blood streamlines connected to the target arteries had contacted the catheter tip.
This study concluded that the location of the catheter tip was integral to controlling the anticancer agent, as the anticancer agents’ distribution rate into the tumor-feeding artery increased when the catheter tip was oriented below and toward a target artery. One limitation of this study, however, involved high wall shear stress at the target artery. This could occur based on the shape of the patient’s vessel, and may cause serious complications during treatment. Further research will allow scientists to develop more successful chemotherapy treatments for oral cancer.
- H. Kitajima, et al. Computational fluid dynamics study of intra-arterial chemotherapy for oral cancer. BioMedical Engineering OnLine (2017), doi: 10.1186/s12938-017-0348-5