Indication and Possibility of Boron Neutron Capture Therapy in Head and Neck Cancer

Background:Boron neutron capture therapy(BNCT) is a targeted type of radiotherapy that has a number of significant advantages over conventional external beam photon irradiation, especially in that radiation can be selectively delivered to tumor cells. We had, first in the world, treated with BNCT for a patient with recurrent head and neck cancer(HNC) in 2001. Methods:From December, 2001 to February, 2013, we had treated 37 patients with recurrent HNC by means of 54 applications of BNCT at Kyoto University Research Reactor Institute(KURRI) and Japan Atomic Energy Agency(JAEA). All of them had received standard therapy and subsequently developed recurrent disease for which there were no other treatment options. Results:All of the (1)Regression rates were complete response(CR):19patients(51%), partial response(PR):14(38%), progressive disease(PD):3(8%), and not evaluated(NE):1(3%)patient. (2)The overall patient response rate was 91%, though all the patients had advanced disease. The 4-year and 7-year OS rates were 42% and 36%, respectively. (3)BNCT improved quality of life(QOL), performance status(PS) and survival times. (5)The primary adverse events were brain necrosis, osteomyelitis and transient mucositis and alopecia. Conclusions:Our results indicate that we could make sure that safety and effectiveness of BNCT, and BNCT represents a new and promising treatment modality in patients for whom there are no other treatment options.