Compassionate Treatment of Brainstem Tumors with Boron Neutron Capture Therapy: A Case Series

Author:

Chen Yi-Wei,Lee Yi-Yen,Lin Chun-Fu,Huang Ting-Yu,Ke Shih-Hung,Mu Pei-Fan,Pan Po-Shen,Chen Jen-Kun,Lan Tien-Li,Hsu Ping-Chuan,Liang Muh-Lii,Chen Hsin-Hung,Chang Feng-Chi,Wu Chih-Chun,Lin Shih-Chieh,Lee Jia-Cheng,Chen Shih-KuanORCID,Liu Hong-Ming,Peir Jinn-JerORCID,Tsai Hui-YuORCID,Lin Ko-Han,Peng Nan-Jing,Chen Kuan-HsuanORCID,Wu Yuan-HungORCID,Kang Yu-Mei,Yang Wan-Chin,Liou Shueh-Chun,Huang Wei-Hsuan,Tanaka Hiroki,Wong Tai-TongORCID,Chao YeeORCID,Chou Fong-In

Abstract

Brainstem tumors are heterogenous and cancerous glioma tumors arising from the midbrain, pons, and the medulla that are relatively common in children, accounting for 10% to 20% of all pediatric brain tumors. However, the prognosis of aggressive brainstem gliomas remains extremely poor despite aggressive treatment with chemotherapy and radiotherapy. That means there are many life-threatening patients who have exhausted all available treatment options and are beginning to face end-of-life stage. Therefore, the unique properties of highly selective heavy particle irradiation with boron neutron capture therapy (BNCT) may be well suited to prolong the lives of patients with end-stage brainstem gliomas. Herein, we report a case series of life-threatening patients with end-stage brainstem glioma who eligible for Emergency and Compassionate Use, in whom we performed a scheduled two fractions of salvage BNCT strategy with low treatment dosage each time. No patients experienced acute or late adverse events related to BNCT. There were 3 patients who relapsed after two fractionated BNCT treatment, characterized by younger age, lower T/N ratio, and receiving lower treatment dose. Therefore, two fractionated low-dose BNCT may be a promising treatment for end-stage brainstem tumors. For younger patients with low T/N ratios, more fractionated low-dose BNCT should be considered.

Publisher

MDPI AG

Subject

Paleontology,Space and Planetary Science,General Biochemistry, Genetics and Molecular Biology,Ecology, Evolution, Behavior and Systematics

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