L-Boronophenylalanine-Mediated Boron Neutron Capture Therapy for Malignant Glioma Progressing After External Beam Radiation Therapy: A Phase I Study

Journal Article · Wed Jun 01 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.02.031· OSTI ID:21499738

Kankaanranta, Leena ^[1]; Seppaelae, Tiina; Koivunoro, Hanna ^[1]; Vaelimaeki, Petteri ^[2]; Beule, Annette ^[3]; Collan, Juhani ^[1]; Kortesniemi, Mika ^[3]; Uusi-Simola, Jouni ^[2]; Kotiluoto, Petri; Auterinen, Iiro; Seren, Tom ^[4]; Paetau, Anders ^[5]; Saarilahti, Kauko ^[1]; Savolainen, Sauli ^[2]; Joensuu, Heikki ^[1]

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1. Department of Oncology, Helsinki University Central Hospital, Helsinki (Finland)
2. Department of Physics, University of Helsinki, Helsinki (Finland)
3. HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland)
4. VTT Technical Research Centre of Finland, Espoo (Finland)
5. Department of Pathology, Helsinki University Central Hospital, Helsinki (Finland)

Purpose: To investigate the safety of boronophenylalanine-mediated boron neutron capture therapy (BNCT) in the treatment of malignant gliomas that progress after surgery and conventional external beam radiation therapy. Methods and Materials: Adult patients who had histologically confirmed malignant glioma that had progressed after surgery and external beam radiotherapy were eligible for this Phase I study, provided that >6 months had elapsed from the last date of radiation therapy. The first 10 patients received a fixed dose, 290 mg/kg, of L-boronophenylalanine-fructose (L-BPA-F) as a 2-hour infusion before neutron irradiation, and the remaining patients were treated with escalating doses of L-BPA-F, either 350 mg/kg, 400 mg/kg, or 450 mg/kg, using 3 patients on each dose level. Adverse effects were assessed using National Cancer Institute Common Toxicity Criteria version 2.0. Results: Twenty-two patients entered the study. Twenty subjects had glioblastoma, and 2 patients had anaplastic astrocytoma, and the median cumulative dose of prior external beam radiotherapy was 59.4 Gy. The maximally tolerated L-BPA-F dose was reached at the 450 mg/kg level, where 4 of 6 patients treated had a grade 3 adverse event. Patients who were given >290 mg/kg of L-BPA-F received a higher estimated average planning target volume dose than those who received 290 mg/kg (median, 36 vs. 31 Gy [W, i.e., a weighted dose]; p = 0.018). The median survival time following BNCT was 7 months. Conclusions: BNCT administered with an L-BPA-F dose of up to 400 mg/kg as a 2-hour infusion is feasible in the treatment of malignant gliomas that recur after conventional radiation therapy.

• OSTI ID: 21499738
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 80, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2010.02.031; PII: S0360-3016(10)00323-8; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
ALANINES
BORON
BRAIN
FRUCTOSE
GLIOMAS
INFUSION
NEUTRON CAPTURE THERAPY
AMINO ACIDS
BODY
CARBOHYDRATES
CARBOXYLIC ACIDS
CENTRAL NERVOUS SYSTEM
DISEASES
ELEMENTS
HEXOSES
INTAKE
KETONES
MEDICINE
MONOSACCHARIDES
NEOPLASMS
NERVOUS SYSTEM
NERVOUS SYSTEM DISEASES
NEUTRON THERAPY
NUCLEAR MEDICINE
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANS
RADIOLOGY
RADIOTHERAPY
SACCHARIDES
SEMIMETALS
THERAPY