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Abstract
We retrospectively review outcomes of applying boron neutron capture therapy (BNCT) to unresectable advanced or recurrent head and neck cancers. Patients who were treated with BNCT for either local recurrent or newly diagnosed unresectable head or neck cancers between December 2001 and September 2007 were included. Clinicopathological characteristics and clinical outcomes were retrieved from hospital records. Either a combination of borocaptate sodium and boronophenylalanine (BPA) or BPA alone were used as boron compounds. In all the treatment cases, the dose constraint was set to deliver a dose <10–12 Gy-eq to the skin or oral mucosa. There was a patient cohort of 62, with a median follow-up of 18.7 months (range, 0.7–40.8). A total of 87 BNCT procedures were performed. The overall response rate was 58% within 6 months after BNCT. The median survival time was 10.1 months from the time of BNCT. The 1- and 2-year overall survival (OS) rates were 43.1% and 24.2%, respectively. The major acute Grade 3 or 4 toxicities were hyperamylasemia (38.6%), fatigue (6.5%), mucositis/stomatitis (9.7%) and pain (9.7%), all of which were manageable. Three patients died of treatment-related toxicity. Three patients experienced carotid artery hemorrhage, two of whom had coexistent infection of the carotid artery. This study confirmed the feasibility of our dose-estimation method and that controlled trials are warranted.
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1 Particle Radiation Oncology Research Center, Research Reactor Institute, Kyoto University, 2-1010, Asashiro-nishi, Kumatori-cho, Sennan-gun, Osaka 590-0494, Japan
2 Department of Oral and Maxillofacial Surgery II, Graduate School of Dentistry, Osaka University, 1-8, Yamada-Oka, Suita, Osaka 565-0871, Japan
3 Department of Otolaryngology and Head and Neck Surgery, Kawasaki Medical School, 577, Matsushima, Kurashiki-City, Okayama 701-0192, Japan
4 Department of Radiation Oncology, Kawasaki Medical School, 577 Matsushima, Kurashiki-City, Okayama 701-0192, Japan
5 Department of Clinical Trial Design and Management, Translational Research Center, Kyoto University Hospital, 54 Kawaracho, Shogoin, Sakyo-ku, Kyoto 606-6507, Japan
6 Department of Dentistry and Oral Surgery, Osaka Medical College, 2-7, Daigaku-machi, Takatsuki Ciy, Osaka 569-8686, Japan
7 Department of Otolaryngology, Osaka Medical College, 2-7, Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan
8 Department of Radiation Life Science, Research Reactor Institute, Kyoto University, 2-1010, Asashiro-nishi, Kumatori-cho, Sennan-gun, Osaka 590-0494, Japan
9 Division of Radiation Safety, Research Reactor Institute, Kyoto University, 2-1010, Asashiro-nishi, Kumatori-cho, Sennan-gun, Osaka 590-0494, Japan