Boron neutron capture therapy for glioblastoma multiforme: clinical studies in Sweden.
A boron neutron capture therapy (BNCT) facility has been constructed at Studsvik, Sweden. It includes two filter/moderator configurations. One of the resulting neutron beams has been optimized for clinical irradiations with a filter/moderator system that allows easy variation of the neutron spectrum from the thermal to the epithermal energy range. The other beam has been designed to produce a large uniform field of thermal neutrons for radiobiological research. Scientific operations of the Studsvik BNCT project are overseen by the Scientific Advisory Board comprised of representatives of major universities in Sweden. Furthermore, special task groups for clinical and preclinical studies have been formed to facilitate collaboration with academia. The clinical Phase II trials for glioblastoma are sponsored by the Swedish National Neuro-Oncology Group and, presently, involve a protocol for BNCT treatment of glioblastoma patients who have not received any therapy other than surgery. In this protocol, p-boronophenylalanine (BPA), administered as a 6-h intravenous infusion, is used as the boron delivery agent. As of January 2002, 17 patients were treated. The 6-h infusion of 900 mg BPA/kg body weight was shown to be safe and resulted in the average blood-boron concentration of 24 microg/g (range: 15-32 microg/g) at the time of irradiation (approximately 2-3 h post-infusion). Peak and average weighted radiation doses to the brain were in the ranges of 8.0-15.5 Gy(W) and 3.3-6.1 Gy(W), respectively. So far, no severe BNCT-related acute toxicities have been observed. Due to the short follow-up time, it is too early to evaluate the efficacy of these studies.
Capala
Jacek
J
Studsvik Medical AB, Nyköping, Sweden. Jacek.Capala@Studsvik.se
Stenstam
Britta H
BH
Sköld
Kurt
K
Munck af Rosenschöld
Per
P
Giusti
Valerio
V
Persson
Charlotta
C
Wallin
Eva
E
Brun
Arne
A
Franzen
Lars
L
Carlsson
Jörgen
J
Salford
Leif
L
Ceberg
Crister
C
Persson
Bertil
B
Pellettieri
Luigi
L
Henriksson
Roger
R
D000328:Adult; D001895:Boron / Q000097:blood / Q000493:pharmacokinetics; D016754:Boron Neutron Capture Therapy / Q000009:adverse effects / Q000295:instrumentation; D001921:Brain / Q000473:pathology / Q000528:radiation effects; D001932:Brain Neoplasms / Q000532:radiotherapy*; D005260:Female; D005909:Glioblastoma / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D013548:Sweden
D001895:Boron