Boron neutron capture therapy for newly diagnosed glioblastoma
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概要
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PurposeThe efficacy, safety, and dose distribution of neutron capture therapy (NCT) were evaluated in 15 patients with newly diagnosed glioblastoma.Methods and materialsSeven patients received intraoperative NCT (protocol-1) and eight patients received external beam NCT (protocol-2). Sulfhydryl borane (5 g/body) was administered intravenously. Additionally, p-dihydroxyboryl-phenylalanine (250 mg/kg) was given in protocol-2. The external beam NCT was combined with fractionated photon irradiation.ResultsFour of 15 patients were alive at analysis for a mean follow-up time from diagnosis of 23.0 M. Twelve of the 15 patients were followed up for more than one year, and 10 (83.3%) of the 12 patients maintained their Karnofsky Performance Status (KPS; 90 in eight patients and 100 in two patients) at 12 months. The median overall survival and the time to tumor progression (TTP) for all patients were 25.7 and 11.9 M, respectively. There was no difference in TTP between the protocol-1 (12.0 M) and protocol-2 (11.9 M). The 1- and 2-year survival rates were 80.0% and 53.3%, respectively. Three protocol-1 patients and one protocol-2 patient suffered transient orbital swelling accompanied by double vision (Grade 2); one of the three protocol-1 patients suffered post-epileptic brain swelling (Grade 4) requiring surgical intervention.ConclusionIt is suggested that NCT is effective for survival of newly diagnosed glioblastoma with acceptable adverse effects. Because of the limitation of the present NCT pilot study without the contemporary control arm, it is unconvincing whether the neutron capture reaction led to distinct survival benefits, and further optimized studies on less invasive external beam NCT in large series of patients are warranted.
著者
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Takagaki Masao
Department Of Radiology Osaka Medical College
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KAWABATA Shinji
Department of Neurosurgery, Osaka Medical College
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MIYATAKE Shin-Ichi
Department of Neurosurgery, Osaka Medical College
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KUROIWA Toshihiko
Department of Neurosurgery, Osaka Medical College
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YOKOYAMA Kunio
Department of Neurosurgery, Osaka Medical College
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DOI Atsushi
Department of Neurosurgery, Osaka Medical College
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IIDA Kyoko
Department of Neurosurgery, Osaka Medical College
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MIYATA Shiro
Department of Neurosurgery, Osaka Medical College
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NONOGUCHI Naosuke
Department of Neurosurgery, Osaka Medical College
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MICHIUE Hiroyuki
Department of Neurosurgery, Okayama University
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TAKAHASHI Masatsugu
Department of Radiology, Osaka Medical College
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INOMATA Taisuke
Department of Radiology, Osaka Medical College
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IMAHORI Yoshio
Cancer Intelligence Care System, Inc.
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KIRIHATA Mitsunori
Department of Agriculture, Osaka Prefectural University
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SAKURAI Yoshinori
Particle Radiation Oncology Research Center, Research Reactor Institute, Kyoto University
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MARUHASHI Akira
Particle Radiation Oncology Research Center, Research Reactor Institute, Kyoto University
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KUMADA Hiroaki
Department of Research Reactor and Tandem Accelerator, Nuclear Science Institute, Japan Atomic Energ
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ONO Koji
Particle Radiation Oncology Research Center, Research Reactor Institute, Kyoto University
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