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Cancer is one of the major causes of death all over the world. Conventional chemotherapeutic treatments involve intravenous injection of drugs which is less effective especially in the case of treatment of brain tumours because of the blood brain barrier, which stops the cytotoxic drugs from penetrating the tumour. Also, since the cytotoxic drugs kills any rapidly dividing cells, it causes a lots of other side effects in different parts of the body like bone marrow suppression, hair loss, etc. Hence, an alternative method called Convection enhanced delivery (CED) is used where the drugs are directly infused into the interstitial space of the brain tumour. This helps in bypassing the blood brain barrier and since the drug is directly administered in the lesion, the chances of it having side effects in other parts of the body is also heavily reduced.
Tumours beyond a few millimetres in size can also start forming vascular network for the supply of nutrients, oxygen and other important products needed for their growth. This process is called angiogenesis and is one of the major ways through which the tumour metastasises i.e., spreads in other parts of the body. Anti-angiogenic drugs like Bevacizumab reduce these vasculature through various ways like pruning vessels, blocking angiogenesis, etc.
In this project, realistic heterogeneous nature of human brain tumour has been taken into account. The heterogeneous parameters were obtained from from DCE-MRI data. A computational model of brain tumour was developed in an open-source CFD simulation software, OpenFOAM. Then all the parameters obtained were imported into it in voxel wise manner . The infusion was done at the site with highest plasma volume fraction. The simulation was run for four different cases: (i) Only Cytotoxic (Temozolomide) drug, (ii) Cytotoxic and Anti-angiogenic (Bevacizumab) drug, (iii) Liposome encapsulated Cytotoxic drug and (iv) Liposome encapsulated cytotoxic and Anti-angiogenic drug.
Then, all the cases were compared to analyse the effects of combination treatment as well as that due to introduction of nanoparticles. Since the study was conducted in realistic heterogeneous medium of brain tumour, its effects were also analysed.
Below are the contour plots of heterogeneous parameteres derived from MRI images namely ktran, porosity and plasma volume fraction respectively.