Scalp angiosarcoma treated with linear accelerator-based boron neutron capture therapy: A report of two patients. (March 2022)

• Record Type: Journal Article
• Authors: Igaki, Hiroshi; Murakami, Naoya; Nakamura, Satoshi; Yamazaki, Naoya; Kashihara, Tairo; Takahashi, Akira; Namikawa, Kenjiro; Takemori, Mihiro; Okamoto, Hiroyuki; Iijima, Kotaro; Chiba, Takahito; Nakayama, Hiroki; Takahashi, Ayaka; Kaneda, Tomoya; Takahashi, Kana; Inaba, Koji; Okuma, Kae; Nakayama, Yuko; Shimada, Kazuaki; Nakagama, Hitoshi; Itami, Jun
• Is Part Of: Clinical and translational radiation oncology. Volume 33(2022)
• Page Start: 128
• Page End: 133
• Publication Date: 2022-03
• Subjects: Boron neutron capture therapy (BNCT) -- Linear accelerator-based BNCT system -- Solid-state Li target -- First-in-human study -- Scalp-angiosarcoma; Cancer -- Radiotherapy -- Periodicals; Oncology -- Periodicals; Cancer -- Radiotherapy; Oncology; Radiation Oncology; Neoplasms -- radiotherapy; Translational Medical Research; Periodicals; Electronic journals; Periodicals; 616.9940642
• DOI: 10.1016/j.ctro.2022.02.006
• Languages: English
• ISSNs: 2405-6308

Abstract

Highlights: Scalp-angiosarcoma is difficult to manage, and surgery is the primary therapy. BNCT can deliver highly effective particles more selectively to tumor cells. BNCT requires a high neutron flux that typically can only be supplied by a nuclear reactor. A linear accelerator-based BNCT system that can be installed in a hospital has been developed. Two scalp-angiosarcoma patients were effectively treated by the linear accelerator-based BNCT. Abstract: Purpose: This study reports the first-in-human use of a linear accelerator-based boron neutron capture therapy (BNCT) system and the first treatment of patients with scalp-angiosarcoma with accelerator-based BNCT. Patients and methods: A single-center open-label phase I clinical trial has been conducted using the system since November 2019. Patients with a localized node-negative scalp-angiosarcoma along with the largest diameter of the tumor ≤ 15 cm who refused primary surgery and chemotherapy were enrolled. After administration of boronophenylalanine (BPA), a single treatment of BNCT with the maximum dose delivered to the skin being 12 Gy-Eq was performed. The safety and effectiveness of accelerator-based BNCT therapy for localized scalp angiosarcoma were evaluated. Results: Scalp-angiosarcoma of the two patients did not develop the dose-limiting toxicity in the clinical trial. They reached CR within half a year and did not exhibit in-field failure 20 months after BNCT without any severe treatment-related adverse events. Although a grade 3 adverse event of an asymptomatic but increased serum amylase level was noted in both patients, it relieved without any treatment. Additionally, no severe acute dermatitis was observed for both patients, which is typically seen with conventional primary radiotherapy. Conclusions: It was suggested that BNCT would be a promising treatment modality for scalp-angiosarcoma, which is difficult to treat.