title: Boron neutron capture therapy in the treatment of locally recurred head and neck cancer.
abstract: OBJECTIVE
  Head and neck carcinomas that recur locally after conventional irradiation pose a difficult therapeutic problem. We evaluated safety and efficacy of boron neutron capture therapy (BNCT) in the treatment of such cancers.
  
  
  METHODS
  Twelve patients with inoperable, recurred, locally advanced (rT3, rT4, or rN2) head and neck cancer were treated with BNCT in a prospective, single-center Phase I-II study. Prior treatments consisted of surgery and conventionally fractionated photon irradiation to a cumulative dose of 56-74 Gy administered with or without concomitant chemotherapy. Tumor responses were assessed using the RECIST (Response Evaluation Criteria in Solid Tumors) criteria and adverse effects using the National Cancer Institute common toxicity grading v3.0. Intravenously administered boronophenylalanine-fructose (BPA-F, 400 mg/kg) was used as the boron carrier. Each patient was scheduled to be treated twice with BNCT.
  
  
  RESULTS
  Ten patients received BNCT twice; 2 were treated once. Ten (83%) patients responded to BNCT, and 2 (17%) had tumor growth stabilization for 5.5 and 7.6 months. The median duration of response was 12.1 months; six responses were ongoing at the time of analysis or death (range, 4.9-19.2 months). Four (33%) patients were alive without recurrence with a median follow-up of 14.0 months (range, 12.8-19.2 months). The most common acute adverse effects were mucositis, fatigue, and local pain; 2 patients had a severe (Grade 3) late adverse effect (xerostomia, 1; dysphagia, 1).
  
  
  CONCLUSIONS
  Boron neutron capture therapy is effective and safe in the treatment of inoperable, locally advanced head and neck carcinomas that recur at previously irradiated sites.
authors: Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland.
authors: Leena
authors: L
authors: Kankaanranta
authors: Tiina
authors: T
authors: Seppälä
authors: Hanna
authors: H
authors: Koivunoro
authors: Kauko
authors: K
authors: Saarilahti
authors: Timo
authors: T
authors: Atula
authors: Juhani
authors: J
authors: Collan
authors: Eero
authors: E
authors: Salli
authors: Mika
authors: M
authors: Kortesniemi
authors: Jouni
authors: J
authors: Uusi-Simola
authors: Antti
authors: A
authors: Mäkitie
authors: Marko
authors: M
authors: Seppänen
authors: Heikki
authors: H
authors: Minn
authors: Petri
authors: P
authors: Kotiluoto
authors: Iiro
authors: I
authors: Auterinen
authors: Sauli
authors: S
authors: Savolainen
authors: Mauri
authors: M
authors: Kouri
authors: Heikki
authors: H
authors: Joensuu
mesh_terms: D000328:Adult; D000368:Aged; D001896:Boron Compounds / Q000627:therapeutic use*; D016754:Boron Neutron Capture Therapy / Q000009:adverse effects / Q000379:methods*; D004487:Edema / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005462:Fluorine Radioisotopes / Q000627:therapeutic use; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy*; D011446:Prospective Studies; D011879:Radiotherapy Dosage
chemical_list: C089739:4-boronophenylalanine-fructose; D001896:Boron Compounds; D005462:Fluorine Radioisotopes; D005632:Fructose