Long-survivors of glioblatoma treated with boron neutron capture therapy (BNCT)
Introduction
Since 1998, we have performed BSH-based intra-operative BNCT (IO-BNCT). The clinical outcomes of IO-BNCT were favorable in patients whose GBMs were located within a 4 cm depth from brain surface. However, they were unsatisfactory in patients whose tumor was situated in deeper regions, because neutron fluence delivery into the deep regions was inadequate (Hatanaka and Nakagawa, 1994, Nakagawa and Hatanaka, 1997, Nakagawa et al., 2003). To improve the neutron beam delivery epithermal neutron beam was developed. Moreover, computational dosimetry system based on CT and MRI scan was developed. The introduction of epithermal neutron beam and new modality of dose planning system could make it possible for clinical application of non-operative BNCT (NO-BNCT) using the combination of BSH and BPA. We have shifted from IO-BNCT to NO-BNCT since 2005. We have already reported the clinical results of BNCT using mixed epithermal neutron beams in patients with malignant glioma treated with IO-BNCT (Kageji et al., 2006). In this study, a statistically significant correlation between the gross tumor volume (GTV) dose and median survival time was found. The median survival time was 19.5 months and one- and two-year survival rate was 60.6% and 37.9%, respectively.
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Material and method
We have treated 23 newly-diagnosed GBM patients with BNCT, including 17 patients with IO-BNCT, in which 100 mg/kg of BSH were given, and seven patients with NO-BNCT, in which 250 mg/kg of BPA and 100 mg/kg of BSH were given to patient intravenously. BNCT radiation dose was evaluated with physical boron (Gy) dose and weighted dose (Gy(w)) using JAERI Computational Dosimetry System (JCDS). We analyzed BNCT dose in gross tumor volume (GTV) and clinical target volume (CTV). The GTV was concomitant
Results
Among 23 GBM patients, five patients have survived more than three years after diagnosis (5/24 patients; 21%), including four patients in IO-BNCT, one patient in NO-BNCT. Nineteen patients died within three years after BNCT, including 13 patients in IO-BNCT, six patients in NO-BNCT. Mean value of survival time in long-survivor group was 1861±485 days (range from 1558 to 2710 days). Three patients died of wound infection, myocardial infarction and pneumonia. Two patients are still alive. These
Discussion
Among 23 GBM patients treated with BNCT, there were five patients who survived more than three years after diagnosis without additional chemotherapy such as a temozolomide. There were four and one patients treated with IO- and NO-BNCT, respectively. BNCT radiation dose of late period of IO-BNCT (2001–2004) was 1.1–1.3 times higher than that of early period of IO-BNCT (1998–2001). This dose escalation contributed to the improvement in clinical outcome. The median survival time of early and late
References (5)
- et al.
Clinical results of long-surviving brain tumor patients who underwent boron neutron capture therapy
Int. J. Radiat. Oncol. Biol. Phys.
(1994) - et al.
Boron neutron capture therapy using mixed epthermal and thermal neutron beams in patients with malignant glioma —correlation between radiation dose and radiation injury and clinical outcome
Int. J. Radiat. Oncol. Biol. Phys.
(2006)
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2021, Applied Radiation and IsotopesRadiation-induced meningiomas after BNCT in patients with malignant glioma
2015, Applied Radiation and IsotopesCitation Excerpt :In small series, the clinical results of BNCT for newly-diagnosed GBM have been favorable. The MST in our series was 19.5 months and the 2-, 3-, and 5-year survival rate was 26.1%, 17.4%, and 5.8%, respectively (Kageji et al., 2011, 2014). Others reported an MST of 23.5- (Miyatake et al., 2005, Kawabata et al., 2003, 2009), and 27.1 months (Yamamoto et al., 2009).
Correlation between radiation dose and histopathological findings in patients with gliblastoma treated with boron neutron capture therapy (BNCT)
2014, Applied Radiation and IsotopesCitation Excerpt :Their median survival time was 19.5 months; 2-, 3-, and 5-year survival rates were 26.1%, 17.4% and 5.8%, respectively, and better than in patients subjected to conventional RT alone (Kageji et al., 2011a). The physical- and weighted dose to the minimum gross tumor volume (GTV) was significantly larger in long- than short-term survivors (Kageji et al., 2011b). The curative BNCT radiation dose must be identified from a histopathological perspective.
Nine-year interval recurrence after treatment of boron neutron capture therapy in a patient with glioblastoma: A case report
2014, Applied Radiation and IsotopesCitation Excerpt :We have treated 23 newly-diagnosed GBM patients with BNCT. Among these, 5 (21.7%) survived more than 3 years and 2, including the current patient, survived more than 5 years following diagnosis (Kageji et al., 2011b). Mean survival of the 5 patients was 1861±485 days (range 1558–2710 days); 2 died of wound infections, and 1 of myocardial infarction.
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