Boron Neutron Capture Therapy for glioblastoma multiforme: advantage of prolonged infusion of BPA-f.
OBJECTIVE
To assess possible improved efficacy of Boron Neutron Capture Therapy (BNCT) for glioblastoma multiforme (GBM) using prolonged infusion and a correspondingly higher dose of l-boronophenylalanine, as the fructose complex (BPA-f).


METHODS
The benefit of prolonged infusion was analyzed by comparing the results from a Phase II study using 6 h infusion of BPA-f with those obtained from a Phase I/II study using 2 h of infusion. Median survival time (MST) from diagnosis, patient baseline characteristics, salvage treatment and severe adverse events were considered in the comparison.


RESULTS
MST increased significantly, from 12.8 (95% confidence interval or CI: 10.3-14.0) months with 2 h infusion to 17.7 (95% CI: 13.6-19.9) months with 6 h of infusion. The fraction of patients with WHO grade 3-4 adverse events was similar in the two studies at 13% and 14%, respectively.


CONCLUSIONS
Prolonged infusion was found to be beneficial for the efficacy of BNCT and it is suggested that 6 h infusion of BPA-f should be used in future trials of BNCT for GBM. BNCT, which is a single-day treatment with mild side effects, should be assessed in a controlled trial, as an alternative to 30 daily fractions of conventional fractionated photon therapy over a period of 6 weeks.
Sköld
K
K
Hammercap Medical AB, Stockholm, Sweden. kurt.skold@hammercap.se <kurt.skold@hammercap.se>
H-Stenstam
B
B
Diaz
A Z
AZ
Giusti
V
V
Pellettieri
L
L
Hopewell
J W
JW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001896:Boron Compounds / Q000008:administration & dosage*; D016754:Boron Neutron Capture Therapy; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D005632:Fructose / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005909:Glioblastoma / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D007262:Infusions, Intravenous; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D016879:Salvage Therapy; D055815:Young Adult
C089739:4-boronophenylalanine-fructose; D001896:Boron Compounds; D005632:Fructose