Optimizing treatment using TTfields by changing the frequency during the course of long term tumor treatment
Tumors can be treated with an alternating electric field. The size of cells in the tumor is determined prior to the start of treatment by, for example, biopsy or by inverse electric impedance tomography. A treatment frequency is chosen based on the determined cell size. The cell size can be determined during the course of treatment and the treatment frequency is adjusted to reflect changes in the cell size. A suitable apparatus for this purpose includes a device for measuring the tumor impedance, an AC signal generator with a controllable output frequency, a processor for estimating the size of tumor cells and setting the frequency of the AC signal generator based thereon, and at least one pair of electrodes operatively connected to the AC signal generator such that an alternating electric field is applied to the tumor.
1. A method for adaptively treating a tumor with an alternating electric field, the method comprising the steps of:
applying an alternating electric field having a first frequency to the tumor for a first duration;
determining an impedance of the tumor to account for expected changes in cell size that occur as a result of the applying of the alternating electric field having the first frequency to the tumor for the first duration, wherein the determining of the impedance is based on a measured current after the first duration during which the alternating electric field having the first frequency was applied;
estimating a size of cells in the tumor based on the determined impedance;
selecting a second frequency based on the estimated size of cells; and
applying an alternating electric field to the tumor at the second frequency to treat the tumor to account for changes in cell size that have occurred during the first duration.
2. The method of claim 1 , further comprising the steps of:
waiting for a period of time;
applying an alternating electric field having a third frequency to the tumor;
determining a second impedance of the tumor based on a measured current while the alternating electric field having the third frequency is applied;
estimating a second size of cells in the tumor based on the determined second impedance; selecting a fourth frequency based on the estimated second size of cells; and
applying an alternating electric field to the tumor at the fourth frequency to treat the tumor.
3. The method of claim 2 , wherein the period of time is at least one week.
4. The method of claim 1 , further comprising:
determining a size of the tumor.
5. The method of claim 1 , further comprising:
determining a shape of the tumor.
6. The method of claim 1 , further comprising:
determining a location of the tumor.
7. The method of claim 4 , wherein
the determining the size of cells is made based on a Cole-Cole plot.
8. The method of claim 4 , further comprising the steps of:
imaging the tumor with CT, MRI, or PET to locate portions of the tumor not having blood or cyst fluid; and
estimating the size of cells in the tumor based on a measured impedance of the located portions.
9. The method of claim 2 , wherein
the applying the alternating electric field having the third frequency in interleaved with the applying the alternating electric field having the fourth frequency.
10. An apparatus for adaptively treating a tumor with an alternating electric field, the apparatus comprising:
an electrical impedance tomography device for measuring an impedance of the tumor to account for expected changes in cell size that occur as a result of treating the tumor for a first duration, the electrical impedance tomography device using a frequency such that a size of cells in the tumor can be determined from the measured impedance of the tumor;
an AC signal generator having a controllable output frequency and configured to generate an alternating electrical signal at the output frequency;
a processor configured to control the output frequency of the AC signal generator and to estimate the size of cells in the tumor based on the measured impedance of the tumor while the AC signal generator generates the alternating electrical signal at the output frequency,
further configured to set the frequency of the AC signal generator based on the estimated size of cells in the tumor to a first frequency for the first duration,
further configured to determine the impedance based on a measured current after the first duration during which an alternating electric field having the first frequency was applied, and
further configured to set the frequency of the AC signal generator to a second frequency to account for changes in cell size that have occurred during the first duration; and
at least one pair of electrodes operatively connected to the AC signal generator such that an alternating electric field is applied to the tumor to selectively destroy cells in the tumor.
11. The apparatus of claim 10 , wherein
the size of cells in the tumor is determined based on a Cole-Cole plot.
12. The apparatus of claim 10 , further comprising:
a CT, MRI, or PET imaging device configured to located portions of the tumor not having blood or cyst fluid; and
wherein the electrical impedance tomography device only measures the impedance of the located portions.
13. The apparatus of claim 10 , wherein
the electrical impedance tomography device is configured to make periodic impedance measurements.
14. The apparatus of claim 13 , wherein
the periodicity of the impedance measurements is based on a history of the tumor.
15. The apparatus of claim 13 , wherein
the periodicity of the impedance measurements is based on a type of tumor.
16. The apparatus of claim 10 , wherein
the frequency of the AC signal generator is set based on a spectrum of cell sizes.
17. The apparatus of claim 10 , wherein
the frequency of the AC signal generator is set based on an average cell size.
18. The apparatus of claim 10 , wherein
the processor computes a size of cells in the tumor based on a database look-up table.
19. A method for adaptively treating a tumor with an alternating electric field, the method comprising the steps of:
applying an alternating electric field having a first frequency to the tumor for a first duration;
determining an impedance of the tumor to account for expected changes in cell characteristics that occur as a result of the applying of the alternating electric field having the first frequency for the first duration, wherein the determining of the impedance is based on a measured current after the first duration during which the alternating electric field having the first frequency was applied;
selecting a second frequency based on the determined impedance; and
applying an alternating electric field to the tumor at the second frequency to treat the tumor to account for changes in cell characteristics that have occurred during the first duration.
20. The method according to claim 19 , further comprising the steps of:
waiting for a period of time;
applying an alternating electric field having a third frequency to the tumor;
determining a second impedance of the tumor based on a measured current while the alternating electric field having the third frequency is applied;
selecting a fourth frequency based on the determined second impedance; and
applying an alternating electric field to the tumor at the fourth frequency to treat the tumor.