Boron neutron capture therapy of brain tumors: clinical trials at the finnish facility using boronophenylalanine.
Two clinical trials are currently running at the Finnish dedicated boron neutron capture therapy (BNCT) facility. Between May 1999 and December 2001, 18 patients with supratentorial glioblastoma were treated with boronophenylalanine (BPA)-based BNCT within a context of a prospective clinical trial (protocol P-01). All patients underwent prior surgery, but none had received conventional radiotherapy or cancer chemotherapy before BNCT. BPA-fructose was given as 2-h infusion at BPA-dosages ranging from 290 to 400 mg/kg prior to neutron beam irradiation, which was given as a single fraction from two fields. The average planning target volume dose ranged from 30 to 61 Gy (W), and the average normal brain dose from 3 to 6 Gy (W). The treatment was generally well tolerated, and none of the patients have died during the first months following BNCT. The estimated 1-year overall survival is 61%. In another trial (protocol P-03), three patients with recurring or progressing glioblastoma following surgery and conventional cranial radiotherapy to 50-60 Gy, were treated with BPA-based BNCT using the BPA dosage of 290 mg/kg. The average planning target dose in these patients was 25-29 Gy (W), and the average whole brain dose 2-3 Gy (W). All three patients tolerated brain reirradiation with BNCT, and none died during the first three months following BNCT. We conclude that BPA-based BNCT has been relatively well tolerated both in previously irradiated and unirradiated glioblastoma patients. Efficacy comparisons with conventional photon radiation are difficult due to patient selection and confounding factors such as other treatments given, but the results support continuation of clinical research on BPA-based BNCT.
Joensuu
Heikki
H
Department of Oncology, University of Helsinki, Finland. heikki.joensuu@hus.fi
Kankaanranta
Leena
L
Seppälä
Tiina
T
Auterinen
Iiro
I
Kallio
Merja
M
Kulvik
Martti
M
Laakso
Juha
J
Vähätalo
Jyrki
J
Kortesniemi
Mika
M
Kotiluoto
Petri
P
Serén
Tom
T
Karila
Johanna
J
Brander
Antti
A
Järviluoma
Eija
E
Ryynänen
Päiivi
P
Paetau
Anders
A
Ruokonen
Inkeri
I
Minn
Heikki
H
Tenhunen
Mikko
M
Jääskeläinen
Juha
J
Färkkilä
Markus
M
Savolainen
Sauli
S
D000328:Adult; D000368:Aged; D001895:Boron / Q000097:blood; D001896:Boron Compounds / Q000627:therapeutic use*; D016754:Boron Neutron Capture Therapy / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005387:Finland; D005909:Glioblastoma / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D015996:Survival Rate
D001896:Boron Compounds; D001895:Boron