Boron neutron capture therapy in the treatment of locally recurred head and neck cancer.
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.
Kankaanranta
Leena
L
Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland.
Seppälä
Tiina
T
Koivunoro
Hanna
H
Saarilahti
Kauko
K
Atula
Timo
T
Collan
Juhani
J
Salli
Eero
E
Kortesniemi
Mika
M
Uusi-Simola
Jouni
J
Mäkitie
Antti
A
Seppänen
Marko
M
Minn
Heikki
H
Kotiluoto
Petri
P
Auterinen
Iiro
I
Savolainen
Sauli
S
Kouri
Mauri
M
Joensuu
Heikki
H
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
C089739:4-boronophenylalanine-fructose; D001896:Boron Compounds; D005462:Fluorine Radioisotopes; D005632:Fructose