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

Authors :
Yi-Wei Chen
Yi-Yen Lee
Chun-Fu Lin
Po-Shen Pan
Jen-Kun Chen
Chun-Wei Wang
Shih-Ming Hsu
Yu-Cheng Kuo
Tien-Li Lan
Sanford P. C. Hsu
Muh-Lii Liang
Robert Hsin-Hung Chen
Feng-Chi Chang
Chih-Chun Wu
Shih-Chieh Lin
Hsiang-Kuang Liang
Jia-Cheng Lee
Shih-Kuan Chen
Hong-Ming Liu
Jinn-Jer Peir
Ko-Han Lin
Wen-Sheng Huang
Kuan-Hsuan Chen
Yu-Mei Kang
Shueh-Chun Liou
Chun-Chieh Wang
Ping-Ching Pai
Chih-Wei Li
Daniel Quah Song Chiek
Tai-Tong Wong
Shih-Hwa Chiou
Yee Chao
Hiroki Tanaka
Fong-In Chou
Koji Ono
Source :
Biology, Vol 10, Iss 4, p 334 (2021)
Publication Year :
2021
Publisher :
MDPI AG, 2021.

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.

Details

Language :
English
ISSN :
20797737
Volume :
10
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Biology
Publication Type :
Academic Journal
Accession number :
edsdoj.46b0e8fe32348e1966dab0928c5b6dd
Document Type :
article
Full Text :
https://doi.org/10.3390/biology10040334