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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
 

  • References

  • 1 Combs SE, Adeberg S, Dittmar JO. , et al. Skull base meningiomas: long-term results and patient self-reported outcome in 507 patients treated with fractionated stereotactic radiotherapy (FSRT) or intensity modulated radiotherapy (IMRT). Radiother Oncol 2013; 106 (02) 186-191
    CrossrefPubMedSearch in Google Scholar
  • 2 Kaul D, Budach V, Misch M, Wiener E, Exner S, Badakhshi H. Meningioma of the skull base: long-term outcome after image-guided stereotactic radiotherapy. Cancer Radiother 2014; 18 (08) 730-735
    CrossrefPubMedSearch in Google Scholar
  • 3 Pollock BE, Stafford SL, Link MJ, Garces YI, Foote RL. Single-fraction radiosurgery for presumed intracranial meningiomas: efficacy and complications from a 22-year experience. Int J Radiat Oncol Biol Phys 2012; 83 (05) 1414-1418
    CrossrefPubMedSearch in Google Scholar
  • 4 Tamura Y, Miyatake S, Nonoguchi N. , et al. Boron neutron capture therapy for recurrent malignant meningioma. Case report. J Neurosurg 2006; 105 (06) 898-903
    CrossrefPubMedSearch in Google Scholar
  • 5 Miyatake S, Tamura Y, Kawabata S, Iida K, Kuroiwa T, Ono K. Boron neutron capture therapy for malignant tumors related to meningiomas. Neurosurgery 2007; 61 (01) 82-90 , discussion 90–91
    PubMedSearch in Google Scholar
  • 6 Kawabata S, Hiramatsu R, Kuroiwa T, Ono K, Miyatake S. Boron neutron capture therapy for recurrent high-grade meningiomas. J Neurosurg 2013; 119 (04) 837-844
    CrossrefPubMedSearch in Google Scholar
  • 7 Miyatake S, Kawabata S, Hiramatsu R. , et al. Boron neutron capture therapy for malignant brain tumors. Neurol Med Chir (Tokyo) 2016; 56 (07) 361-371
    CrossrefPubMedSearch in Google Scholar
  • 8 Coderre JA, Morris GM. The radiation biology of boron neutron capture therapy. Radiat Res 1999; 151 (01) 1-18
    CrossrefPubMedSearch in Google Scholar
  • 9 Farr LE, Sweet WH, Robertson JS. , et al. Neutron capture therapy with boron in the treatment of glioblastoma multiforme. Am J Roentgenol Radium Ther Nucl Med 1954; 71 (02) 279-293
    PubMedSearch in Google Scholar
  • 10 Imahori Y, Ueda S, Ohmori Y. , et al. Fluorine-18-labeled fluoroboronophenylalanine PET in patients with glioma. J Nucl Med 1998; 39 (02) 325-333
    PubMedSearch in Google Scholar
  • 11 Imahori Y, Ueda S, Ohmori Y. , et al. Positron emission tomography-based boron neutron capture therapy using boronophenylalanine for high-grade gliomas: part I. Clin Cancer Res 1998; 4 (08) 1825-1832
    PubMedSearch in Google Scholar
  • 12 Miyatake S, Kawabata S, Kajimoto Y. , et al. Modified boron neutron capture therapy for malignant gliomas performed using epithermal neutron and two boron compounds with different accumulation mechanisms: an efficacy study based on findings on neuroimages. J Neurosurg 2005; 103 (06) 1000-1009
    PubMedSearch in Google Scholar
  • 13 Morris GM, Coderre JA, Hopewell JW, Micca PL, Fisher C. Boron neutron capture irradiation of the rat spinal cord: effects of variable doses of borocaptate sodium. Radiother Oncol 1996; 39 (03) 253-259
    CrossrefPubMedSearch in Google Scholar
  • 14 Morris GM, Coderre JA, Micca PL, Fisher CD, Capala J, Hopewell JW. Central nervous system tolerance to boron neutron capture therapy with p-boronophenylalanine. Br J Cancer 1997; 76 (12) 1623-1629
    CrossrefPubMedSearch in Google Scholar
  • 15 Miyatake S, Kawabata S, Nonoguchi N. , et al. Pseudoprogression in boron neutron capture therapy for malignant gliomas and meningiomas. Neuro-oncol 2009; 11 (04) 430-436
    PubMedSearch in Google Scholar
  • 16 Louis DN, Schcithauer BW, Budka H. , et al. Meningiomas. In: Kleihues P, Cavenee WK. , eds. World Health Organization Classification of Tumours. Pathology and genetics of tumours of the nervous system. Lyon, France: IARC Press; 2000: 176-184
    Search in Google Scholar
  • 17 Louis DN, Ohgaki H, Wiestler OD. , et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 2007; 114 (02) 97-109
    CrossrefPubMedSearch in Google Scholar
  • 18 Sun SQ, Hawasli AH, Huang J, Chicoine MR, Kim AH. An evidence-based treatment algorithm for the management of WHO Grade II and III meningiomas. Neurosurg Focus 2015; 38 (03) E3
    PubMedSearch in Google Scholar
  • 19 Kaley T, Barani I, Chamberlain M. , et al. Historical benchmarks for medical therapy trials in surgery- and radiation-refractory meningioma: a RANO review. Neuro-oncol 2014; 16 (06) 829-840
    PubMedSearch in Google Scholar
  • 20 Cornelius JF, Slotty PJ, Steiger HJ, Hänggi D, Polivka M, George B. Malignant potential of skull base versus non-skull base meningiomas: clinical series of 1,663 cases. Acta Neurochir (Wien) 2013; 155 (03) 407-413
    CrossrefPubMedSearch in Google Scholar
  • 21 Kane AJ, Sughrue ME, Rutkowski MJ. , et al. Anatomic location is a risk factor for atypical and malignant meningiomas. Cancer 2011; 117 (06) 1272-1278
    Search in Google Scholar
  • 22 Sade B, Chahlavi A, Krishnaney A, Nagel S, Choi E, Lee JH. World Health Organization Grades II and III meningiomas are rare in the cranial base and spine. Neurosurgery 2007; 61 (06) 1194-1198 , discussion 1198
    CrossrefPubMedSearch in Google Scholar
  • 23 McGovern SL, Aldape KD, Munsell MF, Mahajan A, DeMonte F, Woo SY. A comparison of World Health Organization tumor grades at recurrence in patients with non-skull base and skull base meningiomas. J Neurosurg 2010; 112 (05) 925-933
    CrossrefPubMedSearch in Google Scholar
  • 24 Adeberg S, Hartmann C, Welzel T. , et al. Long-term outcome after radiotherapy in patients with atypical and malignant meningiomas--clinical results in 85 patients treated in a single institution leading to optimized guidelines for early radiation therapy. Int J Radiat Oncol Biol Phys 2012; 83 (03) 859-864
    CrossrefPubMedSearch in Google Scholar
  • 25 Hakim R, Alexander III E, Loeffler JS. , et al. Results of linear accelerator-based radiosurgery for intracranial meningiomas. Neurosurgery 1998; 42 (03) 446-453 , discussion 453–454
    CrossrefPubMedSearch in Google Scholar
  • 26 Ojemann SG, Sneed PK, Larson DA. , et al. Radiosurgery for malignant meningioma: results in 22 patients. J Neurosurg 2000; 93 (Suppl. 03) 62-67
    PubMedSearch in Google Scholar
  • 27 Stafford SL, Pollock BE, Foote RL. , et al. Meningioma radiosurgery: tumor control, outcomes, and complications among 190 consecutive patients. Neurosurgery 2001; 49 (05) 1029-1037 , discussion 1037–1038
    PubMedSearch in Google Scholar
  • 28 Mizumoto M, Oshiro Y, Tsuboi K. Proton beam therapy for intracranial and skull base tumors. Transl Cancer Res 2013; 2 (02) 87-96
    PubMedSearch in Google Scholar
  • 29 Boskos C, Feuvret L, Noel G. , et al. Combined proton and photon conformal radiotherapy for intracranial atypical and malignant meningioma. Int J Radiat Oncol Biol Phys 2009; 75 (02) 399-406
    CrossrefPubMedSearch in Google Scholar
  • 30 Chan AW, Bernstein KD, Adams JA, Parambi RJ, Loeffler JS. Dose escalation with proton radiation therapy for high-grade meningiomas. Technol Cancer Res Treat 2012; 11 (06) 607-614
    CrossrefPubMedSearch in Google Scholar
  • 31 Hug EB, Devries A, Thornton AF. , et al. Management of atypical and malignant meningiomas: role of high-dose, 3D-conformal radiation therapy. J Neurooncol 2000; 48 (02) 151-160
    CrossrefPubMedSearch in Google Scholar
  • 32 Sakurai Y, Ono K. Improvement of dose distribution by central beam shielding in boron neutron capture therapy. Phys Med Biol 2007; 52 (24) 7409-7422
    CrossrefPubMedSearch in Google Scholar
  • 33 Onishi K, Kawabata S, Miyata S. , et al. Evaluation of the biological effects of boron neutron capture therapy for the humanmalignant meningioma cell line IOMM-Lee. Bull Osaka Med Coll 2009; 55 (01) 9-19
    PubMedSearch in Google Scholar