Boron Neutron Capture Therapy for Recurrent Glioblastoma Multiforme: Imaging Evaluation of a Case With Long-Term Local Control and Survival

Shosei Shimizu; Kei Nakai; Yinuo Li; Masashi Mizumoto; Hiroaki Kumada; Eiichi Ishikawa; Tetsuya Yamamoto; Akira Matsumura; Hideyuki Sakurai

doi:10.7759/cureus.33898

Boron Neutron Capture Therapy for Recurrent Glioblastoma Multiforme: Imaging Evaluation of a Case With Long-Term Local Control and Survival

Cureus. 2023 Jan 17;15(1):e33898. doi: 10.7759/cureus.33898. eCollection 2023 Jan.

Authors

Shosei Shimizu¹, Kei Nakai², Yinuo Li¹, Masashi Mizumoto², Hiroaki Kumada¹, Eiichi Ishikawa³, Tetsuya Yamamoto⁴, Akira Matsumura³, Hideyuki Sakurai⁵

Affiliations

¹ Proton Beam Therapy Center, University of Tsukuba Hospital, Tsukuba, JPN.
² Radiation Oncology, University of Tsukuba Hospital, Tsukuba, JPN.
³ Neurosurgery, University of Tsukuba Hospital, Tsukuba, JPN.
⁴ Radiation Oncology, Yokohama City University Hospital, Tsukuba, JPN.
⁵ Radiation Oncology, Tsukuba University, Tsukuba, JPN.

Abstract

Glioblastoma (GBM) is difficult to cure with conventional multimodal treatment and has an extremely poor prognosis. Boron neutron capture therapy (BNCT) is a new particle therapy for malignant tumors in the brain and head and neck region. This radiotherapy utilizes a nuclear reaction between neutrons and a nonradioactive isotope, boron-10. In this method, a boron compound is administered transvenously into the body. The boron compound has the property of being selectively taken up only by the cells of malignant tumors, and the subsequent irradiation with neutrons can destroy malignant tumor cells without damaging normal cells. Since the irradiation dose to normal tissues is reduced in BNCT, it may be possible to re-irradiate malignant tumors that recur after radiotherapy. Clinical trials have reported prolonged survival and safety of BNCT in a small number of patients with refractory malignancies, including GBM, but these reports do not address quality of life or activities of daily living (ADL) after treatment, and there is no information on the assessment of local control by imaging. Here, we report a case of GBM that recurred after surgery, 60 Gy of conventional radiotherapy and standard treatment with temozolomide. The patient achieved long-term local control and survival over five years after BNCT and was able to maintain ADL at home without any specialist care. We describe the case with evaluation using longitudinal magnetic resonance imaging (MRI).

Keywords: adl (activities of daily living); boron neutron capture therapy (bnct); glioblastoma; particle therapy; radiation therapy.

Publication types

Case Reports