Boron Neutron Capture Therapy in the Treatment of Locally Recurred Head-and-Neck Cancer: Final Analysis of a Phase I/II Trial

Journal Article · Sun Jan 01 04:00:00 EST 2012 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2010.09.057· OSTI ID:22055960

Kankaanranta, Leena ^[1]; Seppaelae, Tiina; Koivunoro, Hanna ^[2]; Saarilahti, Kauko ^[1]; Atula, Timo ^[3]; Collan, Juhani ^[1]; Salli, Eero; Kortesniemi, Mika ^[4]; Uusi-Simola, Jouni ^[2]; Vaelimaeki, Petteri ^[2]; Maekitie, Antti ^[3]; Seppaenen, Marko ^[5]; Minn, Heikki ^[6]; Revitzer, Hannu ^[7]; Kouri, Mauri ^[1]; Kotiluoto, Petri; Seren, Tom; Auterinen, Iiro ^[8]; Savolainen, Sauli ^[2]; Joensuu, Heikki ^[1]

---

1. Department of Oncology, Helsinki University Central Hospital, Helsinki (Finland)
2. Department of Physics, University of Helsinki, Helsinki (Finland)
3. Department of Otorhinolaryngology, Helsinki University Central Hospital, Helsinki (Finland)
4. Helsinki and Uusimaa Hospital District Medical Imaging Center, Helsinki University Central Hospital, Helsinki (Finland)
5. Turku PET Centre, Turku University Hospital, Turku (Finland)
6. Department of Oncology, Turku University Central Hospital, Turku (Finland)
7. Aalto University School of Science and Technology, Esopo (Finland)
8. VTT Technical Research Centre of Finland, Espoo (Finland)

Purpose: To investigate the efficacy and safety of boron neutron capture therapy (BNCT) in the treatment of inoperable head-and-neck cancers that recur locally after conventional photon radiation therapy. Methods and Materials: In this prospective, single-center Phase I/II study, 30 patients with inoperable, locally recurred head-and-neck cancer (29 carcinomas and 1 sarcoma) were treated with BNCT. Prior treatments consisted of surgery and conventionally fractionated photon irradiation to a cumulative dose of 50 to 98 Gy administered with or without concomitant chemotherapy. Tumor responses were assessed by use of the RECIST (Response Evaluation Criteria in Solid Tumors) and adverse effects by use of the National Cancer Institute common terminology criteria version 3.0. Intravenously administered L-boronophenylalanine-fructose (400 mg/kg) was administered as the boron carrier. Each patient was scheduled to be treated twice with BNCT. Results: Twenty-six patients received BNCT twice; four were treated once. Of the 29 evaluable patients, 22 (76%) responded to BNCT, 6 (21%) had tumor growth stabilization for 5.1 and 20.3 months, and 1 (3%) progressed. The median progression-free survival time was 7.5 months (95% confidence interval, 5.4-9.6 months). Two-year progression-free survival and overall survival were 20% and 30%, respectively, and 27% of the patients survived for 2 years without locoregional recurrence. The most common acute Grade 3 adverse effects were mucositis (54% of patients), oral pain (54%), and fatigue (32%). Three patients were diagnosed with osteoradionecrosis (each Grade 3) and one patient with soft-tissue necrosis (Grade 4). Late Grade 3 xerostomia was present in 3 of the 15 evaluable patients (20%). Conclusions: Most patients who have inoperable, locally advanced head-and-neck carcinoma that has recurred at a previously irradiated site respond to boronophenylalanine-mediated BNCT, but cancer recurrence after BNCT remains frequent. Toxicity was acceptable. Further research on novel modifications of the method is warranted.

• OSTI ID: 22055960
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 82; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BORON
CARCINOMAS
CHEMOTHERAPY
EVALUATION
FATIGUE
FRUCTOSE
HEAD
IRRADIATION
NECK
NEUTRON CAPTURE THERAPY
OSTEORADIONECROSIS
PAIN
PATIENTS
PHOTONS
RADIATION DOSES
SAFETY
SARCOMAS
SURGERY
SURVIVAL TIME
TOXICITY