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Journal of Neuro-Oncology

, Volume 33, Issue 1–2, pp 141–152 | Cite as

Boron neutron capture therapy for glioblastoma multiforme using p-boronophenylalanine and epithermal neutrons: Trial design and early clinical results

  • Jeffrey A. Coderre
  • Eric H. Elowitz
  • Manjeet Chadha
  • Richard Bergland
  • Jacek Capala
  • Darrel D. Joel
  • Hungyuan B. Liu
  • Daniel N. Slatkin
  • Arjun D. Chanana
Article

Abstract

A Phase I/II clinical trial of boron neutroncapture therapy (BNCT) for glioblastoma multiforme is underwayusing the amino acid analog p-boronophenylalanine (BPA) andthe epithermal neutron beam at the Brookhaven MedicalResearch Reactor. Biodistribution studies were carried out in18 patients at the time of craniotomy usingan i.v. infusion of BPA, solubilized as afructose complex (BPA-F). There were no toxic effectsrelated to the BPA-F administration at doses of130, 170, 210, or 250 mg BPA/kg bodyweight. The tumor/blood, brain/blood and scalp/blood boron concentrationratios were approximately 3.5:1, 1:1 and 1.5:1, respectively.Ten patients have received BNCT following 2-hr infusionsof 250 mg BPA/kg body weight. The averageboron concentration in the blood during the irradiationwas 13.0 ± 1.5 μg 10B/g. The prescribedmaximum dose to normal brain (1 cm3 volume)was 10.5 photon-equivalent Gy (Gy-Eq). Estimated maximum andminimum doses (mean ± sd, n=10)to the tumor volume were 52.6 ± 4.9Gy-Eq (range: 64.4–47.6) and 25.2 ± 4.2 Gy-Eq(range: 32.3–20.0), respectively). The estimated minimum dose tothe target volume (tumor + 2 cm margin)was 12.3 ± 2.7 Gy-Eq (range: 16.2–7.8). Therewere no adverse effects on normal brain. Thescalp showed mild erythema, followed by epilation inthe 8 cm diameter field. Four patients developedrecurrent tumor, apparently in the lower dose (deeper)regions of the target volume, at post-BNCT intervalsof 7, 5, 3.5 and 3 months, respectively.The remaining patients have had less than 4months of post-BNCT follow-up. BNCT, at this startingdose level, appears safe. Plans are underway tobegin the dose escalation phase of this protocol.

boron neutron capture therapy glioblastoma multiforme boronophenylalanine Phase I/II trial epithermal neutrons 

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Copyright information

© Kluwer Academic Publishers 1997

Authors and Affiliations

  • Jeffrey A. Coderre
    • 1
  • Eric H. Elowitz
    • 2
  • Manjeet Chadha
    • 3
  • Richard Bergland
    • 2
  • Jacek Capala
    • 1
  • Darrel D. Joel
    • 1
  • Hungyuan B. Liu
    • 1
  • Daniel N. Slatkin
    • 1
  • Arjun D. Chanana
    • 1
  1. 1.Medical Department Brookhaven National LaboratoryUptonU.S.A
  2. 2.Department of NeurosurgeryBeth Israel Medical CenterNew YorkUSA
  3. 3.Department of Radiation OncologyBeth Israel Medical CenterNew YorkUSA

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