Effectiveness of boron neutron capture therapy for recurrent head and neck malignancies.
It is necessary to explore new treatments for recurrent head and neck malignancies (HNM) to avoid severe impairment of oro-facial structures and functions. Boron neutron capture therapy (BNCT) is tumor-cell targeted radiotherapy that has significant superiority over conventional radiotherapies in principle. We have treated with BNCT 42 times for 26 patients (19 squamous cell carcinomas (SCC), 4 salivary gland carcinomas and 3 sarcomas) with a recurrent and far advanced HNM since 2001. Results of (1) (10)B concentration of tumor/normal tissue ratios (T/N ratio) of FBPA-PET studies were SCC: 1.8-5.7, sarcoma: 2.5-4.0, parotid tumor: 2.5-3.7. (2) Therapeutic effects were CR: 12 cases, PR: 10 cases, PD: 3 cases NE (not evaluated): 1 case. Response rate was 85%. (3) Improvement of QOL such as a relief of severe pain, bleeding, and exudates at the local lesion, improvement of PS, disappearance of ulceration, covered with normal skin and preserved oral and maxillofacial functions and tissues. (4) Survival periods after BNCT were 1-72 months (mean: 13.6 months). Six-year survival rate was 24% by Kaplan-Meier analysis. (5) Adverse-events were transient mucositis and alopecia in most of the cases; three osteomyelitis and one brain necrosis were recognized. These results indicate that BNCT represents a new and promising treatment approach for advanced HNM.
Kato
Itsuro
I
Department of Oral and Maxillofacial Surgery, II Osaka University, Graduate School of Dentistry, Osaka, Japan. katoitsu@dent.osaka-u.ac.jp
Fujita
Yusei
Y
Maruhashi
Akira
A
Kumada
Hiroaki
H
Ohmae
Masatoshi
M
Kirihata
Mitsunori
M
Imahori
Yoshio
Y
Suzuki
Minoru
M
Sakrai
Yoshinori
Y
Sumi
Tetsuro
T
Iwai
Soichi
S
Nakazawa
Mitsuhiro
M
Murata
Isao
I
Miyamaru
Hiroyuki
H
Ono
Koji
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016754:Boron Neutron Capture Therapy / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy*; D049268:Positron-Emission Tomography; D012468:Salivary Gland Neoplasms / Q000401:mortality / Q000532:radiotherapy; D012509:Sarcoma / Q000401:mortality / Q000532:radiotherapy