Fractionated Boron Neutron Capture Therapy in Locally Recurrent Head and Neck Cancer: A Prospective Phase I/II Trial

Journal Article · Sun May 01 00:00:00 EDT 2016 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2016.02.028· OSTI ID:22648653

Wang, Ling-Wei ^[1]; Chen, Yi-Wei ^[1]; Ho, Ching-Yin ^[2]; Hsueh Liu, Yen-Wan ^[3]; Chou, Fong-In ^[3]; Liu, Yuan-Hao ^[4]; Liu, Hong-Ming; Peir, Jinn-Jer ^[5]; Jiang, Shiang-Huei ^[3]; Chang, Chi-Wei ^[2]; Liu, Ching-Sheng ^[1]; Lin, Ko-Han ^[6]; Wang, Shyh-Jen ^[2]; Chu, Pen-Yuan ^[2]; Lo, Wen-Liang; Kao, Shou-Yen ^[2]; others, and

---

1. Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan (China)
2. National Yang-Ming University, Taiwan (China)
3. Institute of Nuclear Engineering and Science, National Tsing Hua University, Taiwan (China)
4. Nuclear Science and Engineering Department, Nanjing University of Aeronautics and Astronautics, Nanjing (China)
5. Nuclear Science and Technology Development Center, National Tsing Hua University, Taiwan (China)
6. Taoyuan Veterans Hospital, Taiwan (China)

Purpose: To investigate the efficacy and safety of fractionated boron neutron capture therapy (BNCT) for recurrent head and neck (H&N) cancer after photon radiation therapy. Methods and Materials: In this prospective phase 1/2 trial, 2-fraction BNCT with intravenous L-boronophenylalanine (L-BPA, 400 mg/kg) was administered at a 28-day interval. Before each fraction, fluorine-18-labeled-BPA–positron emission tomography was conducted to determine the tumor/normal tissue ratio of an individual tumor. The prescription dose (D80) of 20 Gy-Eq per fraction was selected to cover 80% of the gross tumor volume by using a dose volume histogram, while minimizing the volume of oral mucosa receiving >10 Gy-Eq. Tumor responses and adverse effects were assessed using the Response Evaluation Criteria in Solid Tumors v1.1 and the Common Terminology Criteria for Adverse Events v3.0, respectively. Results: Seventeen patients with a previous cumulative radiation dose of 63-165 Gy were enrolled. All but 2 participants received 2 fractions of BNCT. The median tumor/normal tissue ratio was 3.4 for the first fraction and 2.5 for the second, whereas the median D80 for the first and second fraction was 19.8 and 14.6 Gy-Eq, respectively. After a median follow-up period of 19.7 months (range, 5.2-52 mo), 6 participants exhibited a complete response and 6 exhibited a partial response. Regarding acute toxicity, 5 participants showed grade 3 mucositis and 1 participant showed grade 4 laryngeal edema and carotid hemorrhage. Regarding late toxicity, 2 participants exhibited grade 3 cranial neuropathy. Four of six participants (67%) receiving total D80 > 40 Gy-Eq had a complete response. Two-year overall survival was 47%. Two-year locoregional control was 28%. Conclusions: Our results suggested that 2-fraction BNCT with adaptive dose prescription was effective and safe in locally recurrent H&N cancer. Modifications to our protocol may yield more satisfactory results in the future.

• OSTI ID: 22648653
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 95, Issue 1; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BORON
FLUORINE COMPOUNDS
GY RANGE 100-1000
GY RANGE 10-100
HEAD
MUCOUS MEMBRANES
NECK
NEOPLASMS
NEUTRON CAPTURE THERAPY
NEUTRON REACTIONS
RADIATION DOSES