Boron neutron capture therapy for glioblastoma multiforme: clinical studies in Sweden
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A boron neutron capture therapy (BNCT) facility has been constructed at Studsvik, Sweden. It includes two filter/moderator configurations. One of the resulting neutron beams has been optimized for clinical irradiations with a filter/moderator system that allows easy variation of the neutron spectrum from the thermal to the epithermal energy range. The other beam has been designed to produce a large uniform field of thermal neutrons for radiobiological research. Scientific operations of the Studsvik BNCT project are overseen by the Scientific Advisory Board comprised of representatives of major universities in Sweden. Furthermore, special task groups for clinical and preclinical studies have been formed to facilitate collaboration with academia. The clinical Phase II trials for glioblastoma are sponsored by the Swedish National Neuro-Oncology Group and, presently, involve a protocol for BNCT treatment of glioblastoma patients who have not received any therapy other than surgery. In this protocol,p-boronophenylalanine (BPA), administered as a 6-h intravenous infusion, is used as the boron delivery agent. As of January 2002, 17 patients were treated. The 6-h infusion of 900 mg BPA/kg body weight was shown to be safe and resulted in the average blood-boron concentration of 24 µg/g (range: 15–32 µg/g) at the time of irradiation (approximately 2–3 h post-infusion). Peak and average weighted radiation doses to the brain were in the ranges of 8.0–15.5 Gy(W) and 3.3–6.1 Gy(W), respectively. So far, no severe BNCT-related acute toxicities have been observed. Due to the short follow-up time, it is too early to evaluate the efficacy of these studies.
Key wordsBNCT boron neutron capture therapy boronophenylalanine clinical trials glioblastoma multiforme radiation therapy
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- 1.Briesmeister JF: MCNP — A General Monte Carlo N-particle Transport Code. Version 4B, LA-12625-M, Los Alamos National Laboratory, USA, 1997Google Scholar
- 2.DOORS3.2: One, two- and three-dimensional discrete ordinates neutron/photon transport code system. RSICC CODE PACKAGE CCC-650, 1998Google Scholar
- 3.Chanana AD, Capala J, Chadha M, Coderre JA, Diaz AZ, Elowitz EH, Iwai J, Joel D, Liu HB, Ma R, Pendzick N, Peress NS, Shady MS, Slatkin DN, Tyson GW, Wielopolski L: Boron neutron capture therapy for glioblastoma multiforme: interim results from the phase I/II dose-escalation studies. Neurosurgery 44: 1182–1192; discussion 1192–1193, 1999PubMedCrossRefGoogle Scholar
- 4.Aziz T, Press NS, Diaz AZ, Capala J, Chanana AD: Postmortem neuropathological features secondary to boron neutron capture therapy for glioblastoma multiforme. J Neuropathol Exp Neurol 50: 62–73, 2000Google Scholar
- 6.MacDonald D: Response criteria for phase II studies of supratentorial malignant glioma, JCO 8: 1277–1280, 1990Google Scholar
- 10.Wheeler FJ, Nigg DW: Three-dimensional radiation dose distribution analysis for boron neutron capture therapy. Nucl Sci Eng 110: 16–31, 1992Google Scholar
- 12.Coderre JA, Chanana AD, Joel DD, Elowitz EH, Micca PL, Nawrocky MM, Chadha M, Gebbers, JO, Shady M, Peress NS, Slatkin DN: Biodistribution of boronophenylalanine in patients with glioblastoma multiforme: boron concentration correlates with tumour cellularity. Radiat Res 149:163–170, 1998PubMedCrossRefGoogle Scholar
- 13.Bauer WF, Micca PL, White BM: A rapid method for the direct analysis of boron in whole blood by atomic emission spectroscopy. In: Soloway AH, Barth RF, Carpenter DE (eds) Advances in Neutron Capture Therapy. Plenum Press, New York, pp 403–407, 1993Google Scholar
- 17.Kankaanranta L, Seppälä T, Kalli M, Karila J, Aschan C, Seren T, Kortesniemi M, Kotiluoto, E, Järviluoma E, Kulvik M, Laakso J, Brander A, Jääskeläinen J, Vähätalo J, Auterinen I, Savolainen S, Färkkilä M, Joensuu H: First clinical results in the Finnish study on BPA-mediated BNCT in glioblastoma. In: Proceedings of the Ninth International Symposium on Neutron Capture Therapy for Cancer. Osaka, Japan, October, 2000Google Scholar
- 18.Busse PM, Zamenhof RG, Harling OK, Kalpan I, Kaplan J, Chuamg CF, Goorley JT, Kiger WS III, Railey KJ, Tang J, Solares GR, Plamer MR: The Harvard-MIT BNCT program. Overview of the clinical trails and translational research. In: Hawthorne MF, Shelly K, Wiersema RJ (eds) Frontiers in Neutron Capture Therapy. Kluwer Academic/Plenum Publishers, New York, Boston, Dordrecht, London, Moscow, pp 37–60, 2001Google Scholar