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Compassionate Treatment of Brainstem Tumors with Boron Neutron Capture Therapy: A Case Series

Brainstem tumors are heterogenous and cancerous glioma tumors arising from the midbrain, pons, and the medulla that are relatively common in children, accounting for 10% to 20% of all pediatric brain tumors. However, the prognosis of aggressive brainstem gliomas remains extremely poor despite aggres...

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Detalles Bibliográficos
Autores principales: Chen, Yi-Wei, Lee, Yi-Yen, Lin, Chun-Fu, Huang, Ting-Yu, Ke, Shih-Hung, Mu, Pei-Fan, Pan, Po-Shen, Chen, Jen-Kun, Lan, Tien-Li, Hsu, Ping-Chuan, Liang, Muh-Lii, Chen, Hsin-Hung, Chang, Feng-Chi, Wu, Chih-Chun, Lin, Shih-Chieh, Lee, Jia-Cheng, Chen, Shih-Kuan, Liu, Hong-Ming, Peir, Jinn-Jer, Tsai, Hui-Yu, Lin, Ko-Han, Peng, Nan-Jing, Chen, Kuan-Hsuan, Wu, Yuan-Hung, Kang, Yu-Mei, Yang, Wan-Chin, Liou, Shueh-Chun, Huang, Wei-Hsuan, Tanaka, Hiroki, Wong, Tai-Tong, Chao, Yee, Chou, Fong-In
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025803/
https://www.ncbi.nlm.nih.gov/pubmed/35455057
http://dx.doi.org/10.3390/life12040566
Descripción
Sumario:Brainstem tumors are heterogenous and cancerous glioma tumors arising from the midbrain, pons, and the medulla that are relatively common in children, accounting for 10% to 20% of all pediatric brain tumors. However, the prognosis of aggressive brainstem gliomas remains extremely poor despite aggressive treatment with chemotherapy and radiotherapy. That means there are many life-threatening patients who have exhausted all available treatment options and are beginning to face end-of-life stage. Therefore, the unique properties of highly selective heavy particle irradiation with boron neutron capture therapy (BNCT) may be well suited to prolong the lives of patients with end-stage brainstem gliomas. Herein, we report a case series of life-threatening patients with end-stage brainstem glioma who eligible for Emergency and Compassionate Use, in whom we performed a scheduled two fractions of salvage BNCT strategy with low treatment dosage each time. No patients experienced acute or late adverse events related to BNCT. There were 3 patients who relapsed after two fractionated BNCT treatment, characterized by younger age, lower T/N ratio, and receiving lower treatment dose. Therefore, two fractionated low-dose BNCT may be a promising treatment for end-stage brainstem tumors. For younger patients with low T/N ratios, more fractionated low-dose BNCT should be considered.