Salvage boron neutron capture therapy for malignant brain tumor patients in compliance with emergency and compassionate use: Evaluation of 34 cases in Taiwan

Yi Wei Chen; Yi Yen Lee; Chun Fu Lin; Po Shen Pan; Jen Kun Chen; Chun Wei Wang; Shih Ming Hsu; Yu Cheng Kuo; Tien Li Lan; Sanford P.C. Hsu; Muh Lii Liang; Robert Hsin Hung Chen; Feng Chi Chang; Chih Chun Wu; Shih Chieh Lin; Hsiang Kuang Liang; Jia Cheng Lee; Shih Kuan Chen; Hong Ming Liu; Jinn Jer Peir; Ko Han Lin; Wen Sheng Huang; Kuan Hsuan Chen; Yu Mei Kang; Shueh Chun Liou; Chun Chieh Wang; Ping Ching Pai; Chih Wei Li; Daniel Quah Song Chiek; Tai Tong Wong; Shih Hwa Chiou; Yee Chao; Hiroki Tanaka; Fong In Chou; Koji Ono

doi:10.3390/biology10040334

Salvage boron neutron capture therapy for malignant brain tumor patients in compliance with emergency and compassionate use: Evaluation of 34 cases in Taiwan

Yi Wei Chen, Yi Yen Lee, Chun Fu Lin, Po Shen Pan, Jen Kun Chen, Chun Wei Wang, Shih Ming Hsu, Yu Cheng Kuo, Tien Li Lan, Sanford P.C. Hsu, Muh Lii Liang, Robert Hsin Hung Chen, Feng Chi Chang, Chih Chun Wu, Shih Chieh Lin, Hsiang Kuang Liang, Jia Cheng Lee, Shih Kuan Chen, Hong Ming Liu, Jinn Jer PeirKo Han Lin, Wen Sheng Huang, Kuan Hsuan Chen, Yu Mei Kang, Shueh Chun Liou, Chun Chieh Wang, Ping Ching Pai, Chih Wei Li, Daniel Quah Song Chiek, Tai Tong Wong, Shih Hwa Chiou, Yee Chao, Hiroki Tanaka, Fong In Chou^*, Koji Ono

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Although boron neutron capture therapy (BNCT) is a promising treatment option for malignant brain tumors, the optimal BNCT parameters for patients with immediately life-threatening, end-stage brain tumors remain unclear. We performed BNCT on 34 patients with life-threatening, end-stage brain tumors and analyzed the relationship between survival outcomes and BNCT parameters. Before BNCT, MRI and¹⁸F-BPA-PET analyses were conducted to identify the tumor location/distribution and the tumor-to-normal tissue uptake ratio (T/N ratio) of¹⁸F-BPA. No severe adverse events were observed (grade ≥ 3). The objective response rate and disease control rate were 50.0% and 85.3%, respectively. The mean overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS) times were 7.25, 7.80, and 4.18 months, respectively. Remarkably, the mean OS, CSS, and RFS of patients who achieved a complete response were 17.66, 22.5, and 7.50 months, respectively. Kaplan–Meier analysis identified the optimal BNCT parameters and tumor characteristics of these patients, including a T/N ratio ≥ 4, tumor volume < 20 mL, mean tumor dose ≥ 25 Gy-E, MIB-1 ≤ 40, and a lower recursive partitioning analysis (RPA) class. In conclusion, for malignant brain tumor patients who have exhausted all available treatment options and who are in an immediately life-threatening condition, BNCT may be considered as a therapeutic approach to prolong survival.

Original language	English
Article number	334
Number of pages	16
Journal	Biology
Volume	10
Issue number	4
DOIs	https://doi.org/10.3390/biology10040334
State	Published - Apr 2021

Keywords

BNCT
Glioblastoma
Radioresistance
T/B ratio
T/N ratio

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3390/biology10040334

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Chen, Y. W., Lee, Y. Y., Lin, C. F., Pan, P. S., Chen, J. K., Wang, C. W., Hsu, S. M., Kuo, Y. C., Lan, T. L., Hsu, S. P. C., Liang, M. L., Chen, R. H. H., Chang, F. C., Wu, C. C., Lin, S. C., Liang, H. K., Lee, J. C., Chen, S. K., Liu, H. M., ... Ono, K. (2021). Salvage boron neutron capture therapy for malignant brain tumor patients in compliance with emergency and compassionate use: Evaluation of 34 cases in Taiwan. Biology, 10(4), Article 334. https://doi.org/10.3390/biology10040334

@article{7ef37c56b67745b9b83985a02abc78df,

title = "Salvage boron neutron capture therapy for malignant brain tumor patients in compliance with emergency and compassionate use: Evaluation of 34 cases in Taiwan",

abstract = "Although boron neutron capture therapy (BNCT) is a promising treatment option for malignant brain tumors, the optimal BNCT parameters for patients with immediately life-threatening, end-stage brain tumors remain unclear. We performed BNCT on 34 patients with life-threatening, end-stage brain tumors and analyzed the relationship between survival outcomes and BNCT parameters. Before BNCT, MRI and18F-BPA-PET analyses were conducted to identify the tumor location/distribution and the tumor-to-normal tissue uptake ratio (T/N ratio) of18F-BPA. No severe adverse events were observed (grade ≥ 3). The objective response rate and disease control rate were 50.0% and 85.3%, respectively. The mean overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS) times were 7.25, 7.80, and 4.18 months, respectively. Remarkably, the mean OS, CSS, and RFS of patients who achieved a complete response were 17.66, 22.5, and 7.50 months, respectively. Kaplan–Meier analysis identified the optimal BNCT parameters and tumor characteristics of these patients, including a T/N ratio ≥ 4, tumor volume < 20 mL, mean tumor dose ≥ 25 Gy-E, MIB-1 ≤ 40, and a lower recursive partitioning analysis (RPA) class. In conclusion, for malignant brain tumor patients who have exhausted all available treatment options and who are in an immediately life-threatening condition, BNCT may be considered as a therapeutic approach to prolong survival.",

keywords = "BNCT, Glioblastoma, Radioresistance, T/B ratio, T/N ratio",

author = "Chen, {Yi Wei} and Lee, {Yi Yen} and Lin, {Chun Fu} and Pan, {Po Shen} and Chen, {Jen Kun} and Wang, {Chun Wei} and Hsu, {Shih Ming} and Kuo, {Yu Cheng} and Lan, {Tien Li} and Hsu, {Sanford P.C.} and Liang, {Muh Lii} and Chen, {Robert Hsin Hung} and Chang, {Feng Chi} and Wu, {Chih Chun} and Lin, {Shih Chieh} and Liang, {Hsiang Kuang} and Lee, {Jia Cheng} and Chen, {Shih Kuan} and Liu, {Hong Ming} and Peir, {Jinn Jer} and Lin, {Ko Han} and Huang, {Wen Sheng} and Chen, {Kuan Hsuan} and Kang, {Yu Mei} and Liou, {Shueh Chun} and Wang, {Chun Chieh} and Pai, {Ping Ching} and Li, {Chih Wei} and Chiek, {Daniel Quah Song} and Wong, {Tai Tong} and Chiou, {Shih Hwa} and Yee Chao and Hiroki Tanaka and Chou, {Fong In} and Koji Ono",

note = "Publisher Copyright: {\textcopyright} 2021 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2021",

month = apr,

doi = "10.3390/biology10040334",

language = "English",

volume = "10",

journal = "Biology",

issn = "2079-7737",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "4",

}

Chen, YW, Lee, YY, Lin, CF, Pan, PS, Chen, JK, Wang, CW, Hsu, SM, Kuo, YC, Lan, TL, Hsu, SPC, Liang, ML, Chen, RHH, Chang, FC, Wu, CC, Lin, SC, Liang, HK, Lee, JC, Chen, SK, Liu, HM, Peir, JJ, Lin, KH, Huang, WS, Chen, KH, Kang, YM, Liou, SC, Wang, CC, Pai, PC, Li, CW, Chiek, DQS, Wong, TT, Chiou, SH, Chao, Y, Tanaka, H, Chou, FI & Ono, K 2021, 'Salvage boron neutron capture therapy for malignant brain tumor patients in compliance with emergency and compassionate use: Evaluation of 34 cases in Taiwan', Biology, vol. 10, no. 4, 334. https://doi.org/10.3390/biology10040334

TY - JOUR

T1 - Salvage boron neutron capture therapy for malignant brain tumor patients in compliance with emergency and compassionate use

T2 - Evaluation of 34 cases in Taiwan

AU - Chen, Yi Wei

AU - Lee, Yi Yen

AU - Lin, Chun Fu

AU - Pan, Po Shen

AU - Chen, Jen Kun

AU - Wang, Chun Wei

AU - Hsu, Shih Ming

AU - Kuo, Yu Cheng

AU - Lan, Tien Li

AU - Hsu, Sanford P.C.

AU - Liang, Muh Lii

AU - Chen, Robert Hsin Hung

AU - Chang, Feng Chi

AU - Wu, Chih Chun

AU - Lin, Shih Chieh

AU - Liang, Hsiang Kuang

AU - Lee, Jia Cheng

AU - Chen, Shih Kuan

AU - Liu, Hong Ming

AU - Peir, Jinn Jer

AU - Lin, Ko Han

AU - Huang, Wen Sheng

AU - Chen, Kuan Hsuan

AU - Kang, Yu Mei

AU - Liou, Shueh Chun

AU - Wang, Chun Chieh

AU - Pai, Ping Ching

AU - Li, Chih Wei

AU - Chiek, Daniel Quah Song

AU - Wong, Tai Tong

AU - Chiou, Shih Hwa

AU - Chao, Yee

AU - Tanaka, Hiroki

AU - Chou, Fong In

AU - Ono, Koji

PY - 2021/4

Y1 - 2021/4

N2 - Although boron neutron capture therapy (BNCT) is a promising treatment option for malignant brain tumors, the optimal BNCT parameters for patients with immediately life-threatening, end-stage brain tumors remain unclear. We performed BNCT on 34 patients with life-threatening, end-stage brain tumors and analyzed the relationship between survival outcomes and BNCT parameters. Before BNCT, MRI and18F-BPA-PET analyses were conducted to identify the tumor location/distribution and the tumor-to-normal tissue uptake ratio (T/N ratio) of18F-BPA. No severe adverse events were observed (grade ≥ 3). The objective response rate and disease control rate were 50.0% and 85.3%, respectively. The mean overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS) times were 7.25, 7.80, and 4.18 months, respectively. Remarkably, the mean OS, CSS, and RFS of patients who achieved a complete response were 17.66, 22.5, and 7.50 months, respectively. Kaplan–Meier analysis identified the optimal BNCT parameters and tumor characteristics of these patients, including a T/N ratio ≥ 4, tumor volume < 20 mL, mean tumor dose ≥ 25 Gy-E, MIB-1 ≤ 40, and a lower recursive partitioning analysis (RPA) class. In conclusion, for malignant brain tumor patients who have exhausted all available treatment options and who are in an immediately life-threatening condition, BNCT may be considered as a therapeutic approach to prolong survival.

AB - Although boron neutron capture therapy (BNCT) is a promising treatment option for malignant brain tumors, the optimal BNCT parameters for patients with immediately life-threatening, end-stage brain tumors remain unclear. We performed BNCT on 34 patients with life-threatening, end-stage brain tumors and analyzed the relationship between survival outcomes and BNCT parameters. Before BNCT, MRI and18F-BPA-PET analyses were conducted to identify the tumor location/distribution and the tumor-to-normal tissue uptake ratio (T/N ratio) of18F-BPA. No severe adverse events were observed (grade ≥ 3). The objective response rate and disease control rate were 50.0% and 85.3%, respectively. The mean overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS) times were 7.25, 7.80, and 4.18 months, respectively. Remarkably, the mean OS, CSS, and RFS of patients who achieved a complete response were 17.66, 22.5, and 7.50 months, respectively. Kaplan–Meier analysis identified the optimal BNCT parameters and tumor characteristics of these patients, including a T/N ratio ≥ 4, tumor volume < 20 mL, mean tumor dose ≥ 25 Gy-E, MIB-1 ≤ 40, and a lower recursive partitioning analysis (RPA) class. In conclusion, for malignant brain tumor patients who have exhausted all available treatment options and who are in an immediately life-threatening condition, BNCT may be considered as a therapeutic approach to prolong survival.

KW - BNCT

KW - Glioblastoma

KW - Radioresistance

KW - T/B ratio

KW - T/N ratio

UR - http://www.scopus.com/inward/record.url?scp=85104952726&partnerID=8YFLogxK

U2 - 10.3390/biology10040334

DO - 10.3390/biology10040334

M3 - Article

AN - SCOPUS:85104952726

SN - 2079-7737

VL - 10

JO - Biology

JF - Biology

IS - 4

M1 - 334

ER -

Salvage boron neutron capture therapy for malignant brain tumor patients in compliance with emergency and compassionate use: Evaluation of 34 cases in Taiwan

Abstract

Keywords

UN SDGs

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