P.160 Impact of peritumoral edema during tumor treatment field therapy: a computational modelling study

Background: Tumor treatment fields (TTFields) are an approved adjuvant therapy for glioblastoma. The magnitude of applied electrical field is related to the anti-tumoral response. However, peritumoral edema (ptE) may result in shunting of electrical current around the tumor, thereby reducing the intra-tumoral electric field. In this study, we address this issue with computational simulations. Methods: Finite element models were created with varying amounts of ptE surrounding a virtual tumor. The electric field distribution was simulated using the standard TTFields electrode montage. Electric field magnitude was extracted from the tumor and related to edema thickness. Two patient specific models were created to confirm these results. Results: The inclusion of ptE decreased the magnitude of the electric field within the tumor. In the model considering a frontal tumor and an anterior-posterior electrode configuration, ≥ 6 mm of ptE decreased the electric field by 52%. In the patient specific models, ptE decreased the electric field within the tumor by an average of 26%. The effect of ptE on the electric field distribution was spatially heterogenous. Conclusions: Given the importance of electric field magnitude for the anti-tumoral effects of TTFields, the presence of edema should be considered both in future modelling studies and as a predictor of non-response.