Boron neutron capture therapy using mixed epithermal and thermal neutron beams in patients with malignant glioma-correlation between radiation dose and radiation injury and clinical outcome.

Authors:	Teruyoshi Kageji, Shinji Nagahiro, Kazuhito Matsuzaki, Yoshifumi Mizobuchi, Hiroyuki Toi, Yoshinobu Nakagawa, Hiroaki Kumada
Language:	Eng.
Date:	2006-07-25
Journal:	International journal of radiation oncology, biology, physics (0360-3016)
Release:	Int J Radiat Oncol Biol Phys. 2006 Aug;65(5):1446-55
Abstract:	PURPOSE: To clarify the correlation between the radiation dose and clinical outcome of sodium borocaptate-based intraoperative boron neutron capture therapy in patients with malignant glioma. METHODS AND MATERIALS: The first protocol (P1998, n = 8) prescribed a maximal gross tumor volume (GTV) dose of 15 Gy. In 2001, a dose-escalated protocol was introduced (P2001, n = 11), which prescribed a maximal vascular volume dose of 15 Gy or, alternatively, a clinical target volume (CTV) dose of 18 Gy. RESULTS: The GTV and CTV doses in P2001 were 1.1-1.3 times greater than those in P1998. The maximal vascular volume dose of those with acute radiation injury was 15.8 Gy. The mean GTV and CTV dose in long-term survivors with glioblastoma was 26.4 and 16.5 Gy, respectively. A statistically significant correlation between the GTV dose and median survival time was found. In the 11 glioblastoma patients in P2001, the median survival time was 19.5 months and 1- and 2-year survival rate was 60.6% and 37.9%, respectively. CONCLUSION: Dose escalation contributed to the improvement in clinical outcome. To avoid radiation injury, the maximal vascular volume dose should be <12 Gy. For long-term survival in patients with glioblastoma after boron neutron capture therapy, the optimal mean dose of the GTV and CTV was 26 and 16 Gy, respectively.
Copyright:	International journal of radiation oncology, biology, physics Department of Neurosurgery, Graduate School of Health Biosciences, The University of Tokushima, Tokushima, Japan. kageji clin.med.tokushima-u.ac.jp
Full text:	DOI - International journal of radiation oncology, biology, physics (DOI) EBSCO - HTML (needs subscription) Elsevier Science - HTML (needs subscription) Swets Information Services - HTML (needs subscription)
Terms:	Adolescent, Adult, Aged, Borohydrides, Boron Neutron Capture Therapy, Brain Neoplasms, Child, Child, Preschool, Female, Glioblastoma, Humans, Infant, Magnetic Resonance Imaging, Male, Middle Aged, Neuroectodermal Tumors, Primitive, Radiotherapy Dosage, Sulfhydryl Compounds