Boron Neutron Capture Therapy in the Treatment of Glioblastoma
The First Experiences in the Czech Republic
Honová H., Šafanda M., Petruželka L., 1Burian J., 1Marek M., 1Rejchrt J., 1Sus F. , 2Tovaryš F., 2Dbalý V., 3 Honzátko J., 3 Tomandl I., 4Mareš V.
Onkologická klinika 1. LF UK a VFN, Praha 1Ústav jaderného výzkumu v Řeži, Řež 2Klinika neurochirurgie Nemocnice Na Homolce, Praha 3Ústav jaderné fyziky Akademie věd ČR, Řež Fyziologický ústav AV ČR, Praha
Background. Glioblastoma multiforme is the most frequent primary brain tumor in adults. Despite advances in
surgery, radiotherapy and chemotherapy, its treatment remains unsatisfactory with very limited overall survival. In
the year 2001, in cooperation with Department of Neurosurgery, Nemocnice Na Homolce and Nuclear Research
Institute in Rez, we have started to treat glioblastoma patients with boron neutron capture therapy (BNCT).
Methods and Results. Cells of malignant brain tumors, especially that of glioblastomas, are able to accumulate
boron compounds. If BNCT should be successful, it is necessary to reach selective accumulation of sufficient amount
of 10B in the tumor and low accumulation in the normal brain tissue. After BSH administration, radiation with low
energy thermal neutrons is delivered. It results in nuclear capture and fission reactions with subsequent selective
damage of tumor cells. At the time of analysis 9 patients have been enrolled. Therapy was completed in 5 patients.
Treatment has been very well tolerated. We observed minimal acute toxicity associated with radiation and no
laboratory abnormalities after administrations of BSH. Unfortunately treatment results were quite unsatisfactory.
The median time to progression and overall survival were shorter then expected with conventional treatment.
Conclusions. BNCT is very well tolerated with only a modest toxicity. In contrast to standard radiation, BNCT
patients receive only one dose of radiation. Nevertheless, in this small pilot study first results were inferior when
compared either to outcomes of conventional therapy or to results reported from other BNCT groups. It might be
explained that lower dose of radiation had been used. Further study will show whether the higher dose radiation can
improve treatment results.
glioblastoma multiforme, BSH, neutron capture therapy.