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J Neurol Surg B Skull Base 2018; 79(S 04): S322-S327
DOI: 10.1055/s-0038-1666837
WFSBS 2016
Georg Thieme Verlag KG Stuttgart · New York

Boron Neutron Capture Therapy for High-Grade Skull-Base Meningioma

Koji Takeuchi
1   Department of Neurosurgery, Osaka Medical College, Osaka, Japan
,
Shinji Kawabata
1   Department of Neurosurgery, Osaka Medical College, Osaka, Japan
,
Ryo Hiramatsu
1   Department of Neurosurgery, Osaka Medical College, Osaka, Japan
,
Yoko Matsushita
1   Department of Neurosurgery, Osaka Medical College, Osaka, Japan
,
Hiroki Tanaka
2   Department of Radiation Medical Physics, Research Reactor Institute, Kyoto University, Kumatori, Osaka, Japan
,
Yoshinori Sakurai
2   Department of Radiation Medical Physics, Research Reactor Institute, Kyoto University, Kumatori, Osaka, Japan
,
Minoru Suzuki
3   Department of Particle Radiation Oncology, Research Reactor Institute, Kyoto University, Kumatori, Osaka, Japan
,
Koji Ono
4   Kansai BNCT Medical Center, Osaka Medical College, Osaka, Japan
,
Shin-Ichi Miyatake
5   Section for Advanced Medical Development, Cancer Center, Osaka Medical College, Osaka, Japan
,
Toshihiko Kuroiwa
1   Department of Neurosurgery, Osaka Medical College, Osaka, Japan
› Author Affiliations
Further Information

Publication History

18 February 2018

02 June 2018

Publication Date:
03 July 2018 (online)

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Abstract

Objectives Boron neutron capture therapy (BNCT) is a nuclear reaction-based tumor cell-selective particle irradiation that occurs when nonradioactive Boron-10 is irradiated with low-energy neutrons to produce high-energy α particles (10B [n, α] 7Li). Possible complications associated with extended surgical resection render high-grade meningioma (HGM) a challenging pathology and skull-base meningiomas (SBMs) even more challenging. Lately, we have been trying to control HGMs using BNCT. This study aims to elucidate whether the recurrence and outcome of HGMs and SBMs differ based on their location.

Design Retrospective review.

Setting Osaka Medical College Hospital and Kyoto University Research Reactor Institute.

Participants Between 2005 and 2014, 31 patients with recurrent HGM (7 SBMs) were treated with BNCT.

Main Outcome Measures Overall survival and the subgroup analysis by the anatomical tumor location.

Results Positron emission tomography revealed that HGMs exhibited 3.8 times higher boron accumulation than the normal brain. Although tumors displayed transient increases in size in several cases, all lesions were found to decrease during observation. Furthermore, the median survival time of patients with SBMs post-BNCT and after being diagnosed as high-grade were 24.6 and 67.5 months, respectively (vs non-SBMs: 40.4 and 47.5 months).

Conclusions BNCT could be a robust and beneficial therapeutic modality for patients with high-grade SBMs.

Keywords

boron neutron capture therapy - high-grade meningioma - skull base meningioma - recurrent - boronophenylalanine
 

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