Boron neutron capture therapy of brain tumors: clinical trials at the finnish facility using boronophenylalanine |
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Authors: | Joensuu Heikki Kankaanranta Leena Seppälä Tiina Auterinen Iiro Kallio Merja Kulvik Martti Laakso Juha Vähätalo Jyrki Kortesniemi Mika Kotiluoto Petri Serén Tom Karila Johanna Brander Antti Järviluoma Eija Ryynänen Päiivi Paetau Anders Ruokonen Inkeri Minn Heikki Tenhunen Mikko Jääskeläinen Juha Färkkilä Markus Savolainen Sauli |
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Affiliation: | (1) Department of Physical Sciences, University of Helsinki; VTT Processes, VTT, USA;(2) VTT Processes, VTT, USA;(3) Department of Neurology, and Clinical Research Institute, University of Helsinki, Finland;(4) Department of Clinical Pharmacology, University of Helsinki, Finland;(5) Laboatory of Radiochemistry, University of Helsinki, Finland;(6) Department of Laboratory Diagnostics and Radiology, Helsinki University Central Hospital, Helsinki;(7) Clinical Research Institute and Department of Physical Sciences, VTT Processes, VTT, Finland;(8) Department of Radiology, University of Helsinki, Finland;(9) Department of Pharmacy, University of Helsinki, Finland;(10) Department of Physical Sciences, University of Helsinki, Finland;(11) Department of Pathology, Helsinki University Central Hospital, Helsinki, Finland;(12) Turku PET Centre, Turku;(13) Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland;(14) Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland;(15) Department of Laboratory Diagnostics and Radiology, Helsinki University Central Hospital, Helsinki, Finland;(16) Department of Oncology, Helsinki University Central Hospital, Haartmaninkatu 4, P.O. Box 180, FIN-00029 Helsinki, Finland |
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Abstract: | Summary Two clinical trials are currently running at the Finnish dedicated boron neutron capture therapy (BNCT) facility. Between May 1999 and December 2001, 18 patients with supratentorial glioblastoma were treated with boronophenylalanine (BPA)-based BNCT within a context of a prospective clinical trial (protocol P-01). All patients underwent prior surgery, but none had received conventional radiotherapy or cancer chemotherapy before BNCT. BPA-fructose was given as 2-h infusion at BPA-dosages ranging from 290 to 400 mg/kg prior to neutron beam irradiation, which was given as a single fraction from two fields. The average planning target volume dose ranged from 30 to 61 Gy (W), and the average normal brain dose from 3 to 6 Gy (W). The treatment was generally well tolerated, and none of the patients have died during the first months following BNCT. The estimated 1-year overall survival is 61%. In another trial (protocol P-03), three patients with recurring or progressing glioblastoma following surgery and conventional cranial radiotherapy to 50–60 Gy, were treated with BPA-based BNCT using the BPA dosage of 290 mg/kg. The average planning target dose in these patients was 25–29 Gy (W), and the average whole brain dose 2–3 Gy (W). All three patients tolerated brain reirradiation with BNCT, and none died during the first three months following BNCT. We conclude that BPA-based BNCT has been relatively well tolerated both in previously irradiated and unirradiated glioblastoma patients. Efficacy comparisons with conventional photo radiation are difficult due to patient selection and confounding factors such as other treatments given, but the results support continuation of clinical research on BPA-based BNCT. |
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Keywords: | boron neutron capture therapy BNCT glioblastoma glioma neutron beam radiotherapy radiotherapy |
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