Boron Neutron Capture Therapy in the Treatment of Recurrent Laryngeal Cancer
Menée sur neuf patients atteints d'un cancer du larynx persistant ou récidivant localement et ayant reçu une radiothérapie avec ou sans chimiothérapie concomitante, cette étude évalue l'efficacité, du point de vue de la réponse au traitement, et la sécurité d'une boroneutrothérapie (thérapie par capture de neutrons par le bore)
Purpose : To investigate the safety and efficacy of boron neutron capture therapy (BNCT) as a larynx-preserving treatment option for patients with recurrent laryngeal cancer. Patients and Methods : Six patients with locally recurrent squamous cell laryngeal carcinoma and three patients with persistent laryngeal cancer after prior treatment were treated with BNCT at the XXXX facility (XXXX, XXXX) in 2006 to 2012. The patients had received prior radiotherapy with or without concomitant chemotherapy to a cumulative median dose of 66 Gy. The median tumor diameter was 2.9 cm (range, 1.4 to 10.9 cm) prior to BNCT. BNCT was offered on a compassionate basis to patients who either refused laryngectomy (n =7) or had an inoperable tumor (n=2). Boronophenylalanine-fructose 400mg/kg was used as the boron carrier, and was infused over 2 hours intravenously prior to neutron irradiation. Results : Six patients received BNCT once and three twice. The estimated average gross tumor volume dose ranged from 22 to 38 Gy (W) (mean; 29 Gy [W]). Six of the eight evaluable patients responded to BNCT; two achieved complete and four partial response. One patient died early and was not evaluable for response. Most common side effects were stomatitis, fatigue and oral pain. No life-threatening or grade 4 toxicity was observed. The median time to progression within the target volume was 6.6 months, and the median overall survival time 13.3 months after BNCT. One patient with complete response is alive and disease-free with a functioning larynx 60 months after BNCT. Conclusions : BNCT given after prior external beam radiotherapy is well tolerated. Most patients responded to BNCT, but long-term survival with larynx preservation was infrequent due to cancer progression. Selected patients with recurrent laryngeal cancer may benefit from BNCT.
http://www.redjournal.org/article/S0360-3016%2815%2926704-1/abstract