First clinical case of boron neutron capture therapy for head and neck malignancies using 18F-BPA PET

Abstract

Background: We investigated the application of boron neutron capture therapy (BNCT) to suitable cancers other than glioblastoma and melanoma. Head and neck malignancies were consequently selected as adaptable cancers. We reported the clinical results of our first case treated and discussed several advantages to the application of BNCT to head and neck tumors.

Methods: The patient was a 48-year-old woman with recurrent submandibular gland cancer. We confirmed the p-boronophenylalanine (BPA)-accumulating capacity of the tumor by fluorine-18-labeled p-boronophenylalanine positron emission tomography ((18)F-BPA PET) before BNCT. The tumor/normal tissue boron concentration ratio was 2.9. The patient underwent a preirradiation CT scan for treatment planning performed using the "SERA" software program. The tumor was irradiated at the Kyoto University Research Reactor with epithermal neutrons 5 MW for 90 minutes. The tumor dose and normal tissue dose calculated ranged from 20.0 to 25.2 Gy and from 3.2 to 5.8 Gy, respectively.

Results: To date there has been continuous complete regression in the tumor and no acute and chronic complications for 1.5 years.

Conclusions: Although only 1 patient has shown complete regression and additional long-term follow-up should be required to assess this treatment, we believe that head and neck tumors are suitable for BNCT and that such excellent results will have a great impact on patients in the near future.