Journal Article

Salvage Boron Neutron Capture Therapy for Malignant Brain Tumor Patients in Compliance with Emergency and Compassionate Use: Evaluation of 34 Cases in Taiwan

Chen, Yi-Wei, Chiek, Daniel Quah Song, Lin, Ko-Han, Lee, Jia-Cheng, Li, Chih-Wei, Wong, Tai-Tong, Liang, Hsiang-Kuang, Lee, Yi-Yen, Kuo, Yu-Cheng, Chen, Shih-Kuan, Chen, Jen-Kun, Pan, Po-Shen, Liang, Muh-Lii, Tanaka, Hiroki, Chen, Kuan-Hsuan, Chen, Robert Hsin-Hung, Lin, Shih-Chieh, Pai, Ping-Ching, Liu, Hong-Ming, Chou, Fong-In, Lin, Chun-Fu, Chang, Feng-Chi, Kang, Yu-Mei, Ono, Koji, Hsu, Shih-Ming, Lan, Tien-Li, Wu, Chih-Chun, Wang, Chun-Wei, Wang, Chun-Chieh, Hsu, Sanford P. C., Chiou, Shih-Hwa, Huang, Wen-Sheng, Chao, Yee, Liou, Shueh-Chun, Peir, Jinn-Jer

2021

Overview

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.

• Publisher: MDPI AG,MDPI
• Subject: 2-Methylisoborneol / BNCT / Boron / brain / Brain cancer / brain neoplasms / Brain tumors / Cancer therapies / compliance / Disease control / Drug dosages / FDA approval / glioblastoma / Magnetic resonance imaging / neutrons / Patients / Positron emission tomography / radioresistance / Statistical analysis / Survival / T/B ratio / T/N ratio / Taiwan / therapeutics / Tumors