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Boron neutron capture therapy for glioblastoma multiforme: interim results from the phase I/II dose-escalation studies

Chanana AD; Capala J; Chadha M; Coderre JA; Diaz AZ; Elowitz EH; Iwai J; Joel DD; Liu HB; Ma R; Pendzick N; Peress NS; Shady MS; Slatkin DN; Tyson GW; Wielopolski L
OBJECTIVE: The primary objective of these Phase I/II dose-escalation studies is to evaluate the safety of boronophenylalanine (BPA)-fructose-mediated boron neutron capture therapy (BNCT) for patients with glioblastoma multiforme (GBM). A secondary purpose is to assess the palliation of GBM by BNCT, if possible. METHODS: Thirty-eight patients with GBM have been treated. Subtotal or gross total resection of GBM was performed for 38 patients (median age, 56 yr) before BNCT. BPA-fructose (250 or 290 mg BPA/kg body weight) was infused intravenously, in 2 hours, approximately 3 to 5 weeks after surgery. Neutron irradiation was begun between 34 and 82 minutes after the end of the BPA infusion and lasted 38 to 65 minutes. RESULTS: Toxicity related to BPA-fructose was not observed. The maximal radiation dose to normal brain varied from 8.9 to 14.8 Gy-Eq. The volume-weighted average radiation dose to normal brain tissues ranged from 1.9 to 6.0 Gy-Eq. No BNCT-related Grade 3 or 4 toxicity was observed, although milder toxicities were seen. Twenty-five of 37 assessable patients are dead, all as a result of progressive GBM. No radiation-induced damage to normal brain tissue was observed in postmortem examinations of seven brains. The minimal tumor volume doses ranged from 18 to 55 Gy-Eq. The median time to tumor progression and the median survival time from diagnosis (from Kaplan-Meier curves) were 31.6 weeks and 13.0 months, respectively. CONCLUSION: The BNCT procedure used has been safe for all patients treated to date. Our limited clinical evaluation suggests that the palliation offered by a single session of BNCT is comparable to that provided by fractionated photon therapy. Additional studies with further escalation of radiation doses are in progress
PMID: 10371617
ISSN: 0148-396x
CID: 22745

Neurophysiologicl monitoring and intracranial hypertension

Chapter by: Shady, M; Ettinger, Alan B
in: Pocket companion to Principles & practice of medical intensive care by Kruse, James A [Ed]
Philadelphia : W.B. Saunders, c1996
pp. ?-
ISBN: 9780721656335
CID: 5356122