Body Fluids Modulate Propagation of Tumor Treating Fields

Area of Science:

• Oncology
• Biophysics
• Medical Physics

Background:

• Tumor Treating Fields (TTFields) are nonionizing alternating electric fields with demonstrated anticancer properties.
• TTFields are approved for glioblastoma and are under investigation for lung, ovarian, and pancreatic cancers.
• Unlike ionizing radiation, TTFields exhibit nonlinear propagation, making their precise impact location challenging to ascertain intuitively.

Purpose of the Study:

• To investigate the influence of physiological fluids on the distribution of TTFields within the human body.
• To establish a unified framework for understanding how compartmentalized fluids affect TTFields propagation.
• To aid clinicians in optimizing TTFields therapy by understanding field distribution.

Main Methods:

• Finite element analysis was employed to model and delineate TTFields distribution.
• Simulations were conducted in the brain, pelvis, and thorax to assess field propagation.
• The impact of various physiological fluids (cerebrospinal fluid, edema, urine, ascites, pleural fluid) and tumor necrotic core on TTFields was analyzed.

Main Results:

• Cerebrospinal fluid, edema, urine, ascites, and pleural fluid were identified as significant factors influencing TTFields distribution.
• The presence of a necrotic core within a tumor also affects the propagation of TTFields.
• These fluids alter the nonlinear propagation characteristics of TTFields within different body cavities.

Conclusions:

• Compartmentalized physiological fluids play a critical role in shaping TTFields distribution.
• Understanding fluid dynamics is essential for optimizing the efficacy of TTFields therapy.
• The findings provide a unified model for predicting TTFields behavior in the presence of various body fluids.