|Author||Wang, Ling-Wei ♦ Chen, Yi-Wei ♦ Ho, Ching-Yin ♦ Hsueh Liu, Yen-Wan ♦ Chou, Fong-In ♦ Liu, Yuan-Hao ♦ Liu, Hong-Ming ♦ Peir, Jinn-Jer ♦ Jiang, Shiang-Huei ♦ Chang, Chi-Wei ♦ Liu, Ching-Sheng ♦ Lin, Ko-Han ♦ Wang, Shyh-Jen ♦ Chu, Pen-Yuan ♦ Lo, Wen-Liang ♦ Kao, Shou-Yen|
|Source||United States Department of Energy Office of Scientific and Technical Information|
|Subject Keyword||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|
|Abstract||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.|
|Learning Resource Type||Article|
|Publisher Place||United States|
|Journal||International Journal of Radiation Oncology, Biology and Physics|
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