Patient-Specific Computational Fluid Dynamics Analysis of Anticancer Agent Distribution in Superselective Intra-Arterial Chemotherapy for Oral Cancer

Superselective intra-arterial chemotherapy (SSIAC) presents a promising approach for treating oral cancer by delivering high concentrations of anticancer agents directly to the tumor-feeding arteries. However, drug distribution can be unpredictable, particularly in patients with vascular variations, such as the linguofacial trunk. In this study, we conducted a patient-specific computational fluid dynamics (CFD) analysis using contrast-enhanced computed tomography data obtained from two patients with oral cancer. We created 40 catheter placement models to simulate both the conventional and SSIAC techniques. We analyzed the blood and agent flows using a zero-dimensional resistance boundary model validated in a previous study. The agent distribution ratios to the lingual artery and facial artery varied significantly, whereas the blood flow distribution remained consistent across all the models. High anticancer agent concentration gradients were observed within 2 mm of the catheter tip, indicating that local flow dynamics governed the drug delivery process. No significant correlation was observed between the bifurcation flow angles and agent distribution. This study demonstrates that agent delivery in SSIAC is highly sensitive to the catheter tip location and local blood flow, independent of the blood flow bifurcation angles. Patient-specific CFD may assist clinicians in preoperatively determining the optimal catheter positioning to improve the treatment efficacy.