Clinical trials for treating recurrent head and neck cancer with boron neutron capture therapy using the Tsing-Hua Open Pool Reactor
Abstract Head and neck (HN) cancer is an endemic disease in Taiwan, China. Locally recurrent HN cancer after full-dose irradiation poses a therapeutic challenge, and boron neutron capture therapy (BNCT) may be a solution that could provide durable local control with tolerable toxicity. The Tsing-Hua...
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| Format: | Article |
| Language: | English |
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Wiley
2018-06-01
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| Series: | Cancer Communications |
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| Online Access: | http://link.springer.com/article/10.1186/s40880-018-0295-y |
| _version_ | 1819177470299996160 |
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| author | Ling-Wei Wang Yen-Wan Hsueh Liu Fong-In Chou Shiang-Huei Jiang |
| author_facet | Ling-Wei Wang Yen-Wan Hsueh Liu Fong-In Chou Shiang-Huei Jiang |
| author_sort | Ling-Wei Wang |
| collection | DOAJ |
| description | Abstract Head and neck (HN) cancer is an endemic disease in Taiwan, China. Locally recurrent HN cancer after full-dose irradiation poses a therapeutic challenge, and boron neutron capture therapy (BNCT) may be a solution that could provide durable local control with tolerable toxicity. The Tsing-Hua Open Pool Reactor (THOR) at National Tsing-Hua University in Hsin-Chu, provides a high-quality epithermal neutron source for basic and clinical BNCT research. Our first clinical trial, entitled “A phase I/II trial of boron neutron capture therapy for recurrent head and neck cancer at THOR”, was carried out between 2010 and 2013. A total of 17 patients with 23 recurrent HN tumors who had received high-dose photon irradiation were enrolled in the study. The fructose complex of l-boronophenylalanine was used as a boron carrier, and a two-fraction BNCT treatment regimen at 28-day intervals was used for each patient. Toxicity was acceptable, and although the response rate was high (12/17), re-recurrence within or near the radiation site was common. To obtain better local control, another clinical trial entitled “A phase I/II trial of boron neutron capture therapy combined with image-guided intensity-modulated radiotherapy (IG-IMRT) for locally recurrent HN cancer” was initiated in 2014. The first administration of BNCT was performed according to our previous protocol, and IG-IMRT was initiated 28 days after BNCT. As of May 2017, seven patients have been treated with this combination. The treatment-related toxicity was similar to that previously observed with two BNCT applications. Three patients had a complete response, but locoregional recurrence was the major cause of failure despite initially good responses. Future clinical trials combining BNCT with other local or systemic treatments will be carried out for recurrent HN cancer patients at THOR. |
| first_indexed | 2024-12-22T21:27:10Z |
| format | Article |
| id | doaj.art-f049313821074d6eadd4e7006a35eaf0 |
| institution | Directory Open Access Journal |
| issn | 2523-3548 |
| language | English |
| last_indexed | 2024-12-22T21:27:10Z |
| publishDate | 2018-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Communications |
| spelling | doaj.art-f049313821074d6eadd4e7006a35eaf02022-12-21T18:12:01ZengWileyCancer Communications2523-35482018-06-013811710.1186/s40880-018-0295-yClinical trials for treating recurrent head and neck cancer with boron neutron capture therapy using the Tsing-Hua Open Pool ReactorLing-Wei Wang0Yen-Wan Hsueh Liu1Fong-In Chou2Shiang-Huei Jiang3Department of Oncology, Taipei Veterans General HospitalInstitute of Nuclear Engineering and Science, National Tsing Hua UniversityInstitute of Nuclear Engineering and Science, National Tsing Hua UniversityInstitute of Nuclear Engineering and Science, National Tsing Hua UniversityAbstract Head and neck (HN) cancer is an endemic disease in Taiwan, China. Locally recurrent HN cancer after full-dose irradiation poses a therapeutic challenge, and boron neutron capture therapy (BNCT) may be a solution that could provide durable local control with tolerable toxicity. The Tsing-Hua Open Pool Reactor (THOR) at National Tsing-Hua University in Hsin-Chu, provides a high-quality epithermal neutron source for basic and clinical BNCT research. Our first clinical trial, entitled “A phase I/II trial of boron neutron capture therapy for recurrent head and neck cancer at THOR”, was carried out between 2010 and 2013. A total of 17 patients with 23 recurrent HN tumors who had received high-dose photon irradiation were enrolled in the study. The fructose complex of l-boronophenylalanine was used as a boron carrier, and a two-fraction BNCT treatment regimen at 28-day intervals was used for each patient. Toxicity was acceptable, and although the response rate was high (12/17), re-recurrence within or near the radiation site was common. To obtain better local control, another clinical trial entitled “A phase I/II trial of boron neutron capture therapy combined with image-guided intensity-modulated radiotherapy (IG-IMRT) for locally recurrent HN cancer” was initiated in 2014. The first administration of BNCT was performed according to our previous protocol, and IG-IMRT was initiated 28 days after BNCT. As of May 2017, seven patients have been treated with this combination. The treatment-related toxicity was similar to that previously observed with two BNCT applications. Three patients had a complete response, but locoregional recurrence was the major cause of failure despite initially good responses. Future clinical trials combining BNCT with other local or systemic treatments will be carried out for recurrent HN cancer patients at THOR.http://link.springer.com/article/10.1186/s40880-018-0295-yHead and neck cancerBoron neutron capture therapyTsing-Hua Open Pool ReactorBoronophenylalanine |
| spellingShingle | Ling-Wei Wang Yen-Wan Hsueh Liu Fong-In Chou Shiang-Huei Jiang Clinical trials for treating recurrent head and neck cancer with boron neutron capture therapy using the Tsing-Hua Open Pool Reactor Cancer Communications Head and neck cancer Boron neutron capture therapy Tsing-Hua Open Pool Reactor Boronophenylalanine |
| title | Clinical trials for treating recurrent head and neck cancer with boron neutron capture therapy using the Tsing-Hua Open Pool Reactor |
| title_full | Clinical trials for treating recurrent head and neck cancer with boron neutron capture therapy using the Tsing-Hua Open Pool Reactor |
| title_fullStr | Clinical trials for treating recurrent head and neck cancer with boron neutron capture therapy using the Tsing-Hua Open Pool Reactor |
| title_full_unstemmed | Clinical trials for treating recurrent head and neck cancer with boron neutron capture therapy using the Tsing-Hua Open Pool Reactor |
| title_short | Clinical trials for treating recurrent head and neck cancer with boron neutron capture therapy using the Tsing-Hua Open Pool Reactor |
| title_sort | clinical trials for treating recurrent head and neck cancer with boron neutron capture therapy using the tsing hua open pool reactor |
| topic | Head and neck cancer Boron neutron capture therapy Tsing-Hua Open Pool Reactor Boronophenylalanine |
| url | http://link.springer.com/article/10.1186/s40880-018-0295-y |
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