Salvage Boron Neutron Capture Therapy for Malignant Brain Tumor Patients in Compliance with Emergency and Compassionate Use: Evaluation of 34 Cases in Taiwan
Journal
Biology
Journal Volume
10
Journal Issue
4
Date Issued
2021-04-15
Author(s)
Chen, Yi-Wei
Lee, Yi-Yen
Lin, Chun-Fu
Pan, Po-Shen
Chen, Jen-Kun
Hsu, Shih-Ming
Kuo, Yu-Cheng
Lan, Tien-Li
Hsu, Sanford P C
Liang, Muh-Lii
Chen, Robert Hsin-Hung
Chang, Feng-Chi
Wu, Chih-Chun
Lin, Shih-Chieh
Liang, Hsiang-Kuang
Lee, Jia-Cheng
Chen, Shih-Kuan
Liu, Hong-Ming
Peir, Jinn-Jer
Lin, Ko-Han
Huang, Wen-Sheng
Chen, Kuan-Hsuan
Kang, Yu-Mei
Liou, Shueh-Chun
Wang, Chun-Chieh
Pai, Ping-Ching
Li, Chih-Wei
Chiek, Daniel Quah Song
Wong, Tai-Tong
Chiou, Shih-Hwa
Chao, Yee
Tanaka, Hiroki
Chou, Fong-In
Abstract
Although boron neutron capture therapy (BNCT) is a promising treatment option for malignant brain tumors, the optimal BNCT parameters for patients with immediately life-threatening, end-stage brain tumors remain unclear. We performed BNCT on 34 patients with life-threatening, end-stage brain tumors and analyzed the relationship between survival outcomes and BNCT parameters. Before BNCT, MRI and 18F-BPA-PET analyses were conducted to identify the tumor location/distribution and the tumor-to-normal tissue uptake ratio (T/N ratio) of 18F-BPA. No severe adverse events were observed (grade ≥ 3). The objective response rate and disease control rate were 50.0% and 85.3%, respectively. The mean overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS) times were 7.25, 7.80, and 4.18 months, respectively. Remarkably, the mean OS, CSS, and RFS of patients who achieved a complete response were 17.66, 22.5, and 7.50 months, respectively. Kaplan-Meier analysis identified the optimal BNCT parameters and tumor characteristics of these patients, including a T/N ratio ≥ 4, tumor volume < 20 mL, mean tumor dose ≥ 25 Gy-E, MIB-1 ≤ 40, and a lower recursive partitioning analysis (RPA) class. In conclusion, for malignant brain tumor patients who have exhausted all available treatment options and who are in an immediately life-threatening condition, BNCT may be considered as a therapeutic approach to prolong survival.
Subjects
BNCT; T/B ratio; T/N ratio; glioblastoma; radioresistance
SDGs
Type
journal article