Preliminary dosimetric study on feasibility of multi-beam boron neutron capture therapy in patients with diffuse intrinsic pontine glioma without craniotomy

Jia-Cheng Lee; Keh-Shih Chuang; Yi-Wei Chen; Fang-Yuh Hsu; Fong-In Chou; Sang-Hue Yen; Yuan-Hung Wu

doi:10.1371/journal.pone.0180461

Preliminary dosimetric study on feasibility of multi-beam boron neutron capture therapy in patients with diffuse intrinsic pontine glioma without craniotomy

PLoS One. 2017 Jun 29;12(6):e0180461. doi: 10.1371/journal.pone.0180461. eCollection 2017.

Authors

Jia-Cheng Lee^{1

2}, Keh-Shih Chuang², Yi-Wei Chen^{1

3}, Fang-Yuh Hsu⁴, Fong-In Chou⁴, Sang-Hue Yen¹, Yuan-Hung Wu^{1

3

5

6}

Affiliations

¹ Department Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.
² Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan.
³ School of Medicine, National Yang-Ming University, Taipei, Taiwan.
⁴ Nuclear Science and Technology Development Center, National Tsing Hua University, Hsinchu, Taiwan.
⁵ Institue of Public Health, National Yang-Ming University, Taipei, Taiwan.
⁶ Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.

Abstract

Diffuse intrinsic pontine glioma is a very frustrating disease. Since the tumor infiltrates the brain stem, surgical removal is often impossible. For conventional radiotherapy, the dose constraint of the brain stem impedes attempts at further dose escalation. Boron neutron capture therapy (BNCT), a targeted radiotherapy, carries the potential to selectively irradiate tumors with an adequate dose while sparing adjacent normal tissue. In this study, 12 consecutive patients treated with conventional radiotherapy in our institute were reviewed to evaluate the feasibility of BNCT. NCTPlan Ver. 1.1.44 was used for dose calculations. Compared with two and three fields, the average maximal dose to the normal brain may be lowered to 7.35 ± 0.72 Gy-Eq by four-field irradiation. The mean ratio of minimal dose to clinical target volume and maximal dose to normal tissue was 2.41 ± 0.26 by four-field irradiation. A therapeutic benefit may be expected with multi-field boron neutron capture therapy to treat diffuse intrinsic pontine glioma without craniotomy, while the maximal dose to the normal brain would be minimized by using the four-field setting.

MeSH terms

Adolescent
Adult
Boron Neutron Capture Therapy / methods*
Brain Neoplasms / radiotherapy*
Child
Child, Preschool
Feasibility Studies
Female
Glioma / radiotherapy*
Humans
Male
Middle Aged
Young Adult

Grants and funding

This work was supported by the Taipei Veterans General Hospital (www.vghtpe.gov.tw) No: V105A-046(JCL), V105A-013(YHW), V106A-007(YHW), V106A-016 (JCL), Taipei Veterans General Hospital-National Yang Ming University Excellent Physician Scientists Cultivation Program (www.vghtpe.gov.tw) No. 105-V-B-107(YHW). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.