Boron neutron capture therapy of brain tumors: Clinical trials at the Finnish facility using boronophenylalanine

Heikki Joensuu, Leena Kankaanranta, Tiina Seppälä, Iiro Auterinen, Merja Kallio, Martti Kulvik, Juha Laakso, Jyrki Vähätalo, Mika Kortesniemi, Petri Kotiluoto, Tom Serén, Johanna Karila, Antii Brander, Eija Järviluoma, Päivi Ryynänen, Anders Paetau, Inkeri Ruokonen, Heikki Minn, Mikko Tenhunen, Juha JääskeläinenMarkus Färkkilä, Sauli Savolainen

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Abstract

Two clinical trials are currently running at the Finnish dedicated boron neutron capture therapy (BNCT) facility. Between May 1999 and December 2001, 18 patients with supratentorial glioblastoma were treated with boronophenylalanine (BPA)-based BNCT within a context of a prospective clinical trial (protocol P-01). All patients underwent prior surgery, but none had received conventional radiotherapy or cancer chemotherapy before BNCT. BPA-fructose was given as 2-h infusion at BPA-dosages ranging from 290 to 400 mg/kg prior to neutron beam irradiation, which was given as a single fraction from two fields. The average planning target volume dose ranged from 30 to 61 Gy (W), and the average normal brain dose from 3 to 6 Gy (W). The treatment was generally well tolerated, and none of the patients have died during the first months following BNCT. The estimated 1-year overall survival is 61%. In another trial (protocol P-03), three patients with recurring or progressing glioblastoma following surgery and conventional cranial radiotherapy to 50-60 Gy, were treated with BPA-based BNCT using the BPA dosage of 290 mg/kg. The average planning target dose in these patients was 25-29 Gy (W), and the average whole brain dose 2-3 Gy (W). All three patients tolerated brain reirradiation with BNCT, and none died during the first three months following BNCT. We conclude that BPA-based BNCT has been relatively well tolerated both in previously irradiated and unirradiated glioblastoma patients. Efficacy comparisons with conventional photon radiation are difficult due to patient selection and confounding factors such as other treatments given, but the results support continuation of clinical research on BPA-based BNCT.

Original languageEnglish
Pages (from-to)123-134
Number of pages12
JournalJournal of Neuro-Oncology
Volume62
Issue number1-2
DOIs
Publication statusPublished - 1 Mar 2003
MoE publication typeA1 Journal article-refereed

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Boron Neutron Capture Therapy
Brain Neoplasms
Clinical Trials
Glioblastoma
Clinical Protocols
Brain
Radiotherapy
Neutrons
Fructose
Photons
Patient Selection
Radiation

Keywords

  • BNCT
  • Boron neutron capture therapy
  • Glioblastoma
  • Glioma
  • Neutron beam radiotherapy
  • Radiotherapy

Cite this

Joensuu, Heikki ; Kankaanranta, Leena ; Seppälä, Tiina ; Auterinen, Iiro ; Kallio, Merja ; Kulvik, Martti ; Laakso, Juha ; Vähätalo, Jyrki ; Kortesniemi, Mika ; Kotiluoto, Petri ; Serén, Tom ; Karila, Johanna ; Brander, Antii ; Järviluoma, Eija ; Ryynänen, Päivi ; Paetau, Anders ; Ruokonen, Inkeri ; Minn, Heikki ; Tenhunen, Mikko ; Jääskeläinen, Juha ; Färkkilä, Markus ; Savolainen, Sauli. / Boron neutron capture therapy of brain tumors : Clinical trials at the Finnish facility using boronophenylalanine. In: Journal of Neuro-Oncology. 2003 ; Vol. 62, No. 1-2. pp. 123-134.
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Joensuu, H, Kankaanranta, L, Seppälä, T, Auterinen, I, Kallio, M, Kulvik, M, Laakso, J, Vähätalo, J, Kortesniemi, M, Kotiluoto, P, Serén, T, Karila, J, Brander, A, Järviluoma, E, Ryynänen, P, Paetau, A, Ruokonen, I, Minn, H, Tenhunen, M, Jääskeläinen, J, Färkkilä, M & Savolainen, S 2003, 'Boron neutron capture therapy of brain tumors: Clinical trials at the Finnish facility using boronophenylalanine', Journal of Neuro-Oncology, vol. 62, no. 1-2, pp. 123-134. https://doi.org/10.1023/A:1023293006617

Boron neutron capture therapy of brain tumors : Clinical trials at the Finnish facility using boronophenylalanine. / Joensuu, Heikki; Kankaanranta, Leena; Seppälä, Tiina; Auterinen, Iiro; Kallio, Merja; Kulvik, Martti; Laakso, Juha; Vähätalo, Jyrki; Kortesniemi, Mika; Kotiluoto, Petri; Serén, Tom; Karila, Johanna; Brander, Antii; Järviluoma, Eija; Ryynänen, Päivi; Paetau, Anders; Ruokonen, Inkeri; Minn, Heikki; Tenhunen, Mikko; Jääskeläinen, Juha; Färkkilä, Markus; Savolainen, Sauli.

In: Journal of Neuro-Oncology, Vol. 62, No. 1-2, 01.03.2003, p. 123-134.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Boron neutron capture therapy of brain tumors

T2 - Clinical trials at the Finnish facility using boronophenylalanine

AU - Joensuu, Heikki

AU - Kankaanranta, Leena

AU - Seppälä, Tiina

AU - Auterinen, Iiro

AU - Kallio, Merja

AU - Kulvik, Martti

AU - Laakso, Juha

AU - Vähätalo, Jyrki

AU - Kortesniemi, Mika

AU - Kotiluoto, Petri

AU - Serén, Tom

AU - Karila, Johanna

AU - Brander, Antii

AU - Järviluoma, Eija

AU - Ryynänen, Päivi

AU - Paetau, Anders

AU - Ruokonen, Inkeri

AU - Minn, Heikki

AU - Tenhunen, Mikko

AU - Jääskeläinen, Juha

AU - Färkkilä, Markus

AU - Savolainen, Sauli

PY - 2003/3/1

Y1 - 2003/3/1

N2 - Two clinical trials are currently running at the Finnish dedicated boron neutron capture therapy (BNCT) facility. Between May 1999 and December 2001, 18 patients with supratentorial glioblastoma were treated with boronophenylalanine (BPA)-based BNCT within a context of a prospective clinical trial (protocol P-01). All patients underwent prior surgery, but none had received conventional radiotherapy or cancer chemotherapy before BNCT. BPA-fructose was given as 2-h infusion at BPA-dosages ranging from 290 to 400 mg/kg prior to neutron beam irradiation, which was given as a single fraction from two fields. The average planning target volume dose ranged from 30 to 61 Gy (W), and the average normal brain dose from 3 to 6 Gy (W). The treatment was generally well tolerated, and none of the patients have died during the first months following BNCT. The estimated 1-year overall survival is 61%. In another trial (protocol P-03), three patients with recurring or progressing glioblastoma following surgery and conventional cranial radiotherapy to 50-60 Gy, were treated with BPA-based BNCT using the BPA dosage of 290 mg/kg. The average planning target dose in these patients was 25-29 Gy (W), and the average whole brain dose 2-3 Gy (W). All three patients tolerated brain reirradiation with BNCT, and none died during the first three months following BNCT. We conclude that BPA-based BNCT has been relatively well tolerated both in previously irradiated and unirradiated glioblastoma patients. Efficacy comparisons with conventional photon radiation are difficult due to patient selection and confounding factors such as other treatments given, but the results support continuation of clinical research on BPA-based BNCT.

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KW - Glioblastoma

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KW - Neutron beam radiotherapy

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