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S. Levi
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P3.01 - Advanced NSCLC (ID 621)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.01-088e - TTFields Delivery to the Brain: An Overview of Computational Studies and Implications When Treating Brain Metastases (ID 8773)
09:30 - 09:30 | Author(s): S. Levi
- Abstract
Background:
TTFields is an antimitotic cancer treatment that utilizes alternating electric fields in the intermediate frequency range . TTFields are approved for treating Glioblastoma Multiforme (GBM), and a pivotal trial testing the efficacy of TTFields for treating brain metastases (METIS) is currently underway. TTFields are delivered in two orthogonal directions using 2 pairs of transducer arrays placed on the patient’s scalp. The field distribution within the brain depends on the position of the arrays on the head. Therefore, personalizing array placement to optimize field delivery to the tumor requires a deep understanding of how brain anatomy, tumor position and array position influence the field distribution within the brains of patients. Here we present an overview of computational studies investigating TTFields distribution within the brain
Method:
In order to simulate the delivery of TTFields to the head realistic computational models are constructed by segmenting MRI datasets of both healthy individuals and brain tumor patients. Both healthy and pathological tissues are identified and assigned appropriate dielectric properties. Virtual transducer arrays are placed on scalps of the models and TTFields are created within the models.
Result:
Studies show that the field distribution within the brain is heterogeneous and depends on the anatomy of the model and the location of the arrays on the scalp. By shifting the arrays on the head it is possible to increase the field intensity in the tumor bed by a factor of two or more relative to a generic layout in which arrays are geometrically centered on the head. Optimizing array position, it is possible to guarantee that field intensities within the tumor bed and large portions of the brain exceed the therapeutic threshold of 1 V/cm. One particular layout worth noting is a layout in which each array of one pair are laterally placed superficially to the lower region of the occipital lobe, and the two arrays of the second pair are placed on the calvarium and the superior aspect of the neck. This layout delivers fields above the therapeutic threshold to both the supratentorial and infratentorial regions of the brain, making it suitable for treating multi-focal disease with tumors or metastases in both these regions.
Conclusion:
Optimal delivery of TTFields is layout dependent. The study suggests that TTFields can be used to treat brain tumors and metastases throughout the brain, as well as multi-focal disease encompassing both the supratentorial and infratentorial regions of the brain.
