[Journal] Compassionate boron neutron capture therapy for locally recurrent nasopharyngeal cancer: A retrospective study
2026-02-10
Compassionate boron neutron capture therapy for locally recurrent nasopharyngeal cancer: A retrospective study
Ling-Wei Wang 1 2, Yen-Wan Hsueh Liu 3, Jinn-Jer Peir 4, Ko-Han Lin 2 5, Jia-Cheng Lee 1 6, Pei-Wei Shueng 2 7, Sang-Hue Yen 8, Muh-Hua Yang 2 9
1Department of Heavy Particles and Radiation Oncology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
2School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
3Heron Neutron Medical Corp., Hsinchu, Taiwan, ROC.
4Nuclear Science and Technology Development Center, National Tsing Hua University, Hsinchu, Taiwan, ROC.
5Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
6Department of Medical Imaging and Radiological Technology, Yuanpei University of Medical Technology, Hsinchu, Taiwan, ROC.
7Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC.
8Division of Radiation Oncology, Taipei Municipal Wan Fang Hospital, Taipei, Taiwan, ROC.
9Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Abstract
Background: Boron neutron capture therapy (BNCT) is a targeted form of particle radiotherapy (RT) that better spares normal tissues than does conventional photon RT. We describe our experience with compassionate-use BNCT for locally recurrent nasopharyngeal cancer (rNPC) after prior RT.
Methods: Data from patients with rNPC who received BNCT outside of clinical trials at the Tsing-Hua Open-Pool Reactor between 2020 and 2024 were retrospectively analyzed.
Results: Ten patients (eight men and two women) with a median age of 54 years and recurrent stage T2-T4N0-N1 disease were included. The median radiation dose before BNCT was 70 (range: 70-124) Gy. For the initial BNCT session, the median average tumor dose was 16.4 (range: 11.7-25.1) Gy-Eq delivered in a single fraction. Two patients underwent a second BNCT session for residual or recurrent disease at 3 and 12 months after the first, respectively. The median follow-up period was 10.7 (range: 2.2-50.9) months. Overall, one complete response and one partial response were observed after one or two BNCT sessions among eight evaluable cases. The most common acute toxicities were low-grade mucositis and dermatitis. No cases of carotid blowout syndrome were reported. Temporal lobe necrosis occurred in one patient who received two BNCT sessions. The 1-year overall survival rate was 44.4%, and the 1-year progression-free survival rate was 33%. One patient survived for more than 4 years.
Conclusion: In this small cohort of patients with recurrent NPC, compassionate BNCT with moderate doses yielded a 25% response rate and one long-term survivor (4 years). Protocol modifications involving adjusted dose-fractionation schedules and combination with other treatment modalities in future prospective trials may improve the outcomes for recurrent NPC.
Keywords: Boron neutron capture therapy; Radiotherapy; Recurrent nasopharyngeal cancer.
- PMID: 41501971
- PMCID: PMC12900212
- DOI: 10.1097/JCMA.0000000000001339
