Evaluation of drug distributions in brain tumor therapy: An in silico comparative study of multi-side-hole and standard end-hole catheters in convection-enhanced delivery.

Convection-enhanced delivery (CED) is a promising technique for treating brain tumors by enabling drugs to bypass the blood-brain barrier (BBB). The types of catheters and physicochemical properties of drugs both influence drug distribution within tumors. In this study, based on a 3D brain model reconstructed from magnetic resonance (MR) images, a Computational Fluid Dynamics (CFD) simulation is employed to investigate the effects of a multi-side-hole catheter (MSHC) on the CED administration of six anticancer drugs. Results indicate that reducing catheter diameter at the same infusion rate increases the effective volumes of all six drugs. When administered through the MSHC, five of the six drugs (excluding paclitaxel) show increased effective distribution volumes, while none of the drugs demonstrate higher volume-averaged concentrations. In summary, compared to the standard end-hole catheter (SEHC), the MSHC shows superior therapeutic efficacy for doxorubicin, cisplatin, fluorouracil, and carmustine. When methotrexate is administered via MSHC, it is necessary to balance the increased distribution volume against the reduced volume-averaged concentration. Paclitaxel is more suitable for administration in the SEHC, especially with a low infusion rate and a small-diameter catheter. These findings can provide recommendations for the clinical implementation of CED.