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Histopathological Findings in Autopsied
Glioblastoma Patients Treated by Mixed Neutron Beam BNCT
Teruyoshi Kageji, Shinji Nagahiro, Shinichi Uyama,
Yoshifumi Mizobuchi, Hiroyuki Toi, Muneo Nakamura, Yoshinobu Nakagawa
Department
of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima,
Japan (T.K.,
S.N., S.U., Y.M., H.T.); Department of Pathology, National Zentsuji Hospital,
Kagawa, Japan (M.N.);
Department of Neurosurgery, National Kagawa Children's
Hospital, Kagawa, Japan (Y.N.)
Since 1998, we have introduced a mixed epithermal- and thermal neutron
beam for boron neutron capture therapy (BNCT) to improve the neutron beam
distribution.
Sixteen patients with malignant glioma (glioblastoma, n = 14;
anaplastic ependymoma, n = 1; PNET, n = 1) were treated by
BNCT in Japan.
Of these, 9 died; 3 due to cerebrospinal fluid (CSF) dissemination, 1 each of
tumor invasion, meningitis, pneumonia, and unknown causes, and 2 patients died
of local recurrence or radiation necrosis.
The current postmortem study is comprised of 3 patients with glioblastoma who
were treated with BNCT employing an epithermal neutron beam and sodium
borocaptate (BSH: Na2B12H11SH).
None of the patients manifested local regrowth at the primary site.
However, in 2 patients there was CSF dissemination; tumor cells were recognized
throughout the subarachnoid space.
In the other patient, tumor cells had massively invaded the ipsilateral- and
contralateral hemisphere and brain stem from the bottom of the tumor cavity via
the corpus callosum and cerebral peduncle.
Our findings indicate that BNCT can achieve local control of glioblastoma at the
primary site.
However, to further improve the clinical outcome after BNCT, steps must be taken
to prevent CSF dissemination.
Keywords: boron neutron capture therapy, glioblastoma, neutron beam, radiation
Copyright
©
2004 Kluwer Academic Publishers.
All rights reserved
Source:
http://journals.kluweronline.com/article.asp?PIPS=5266137
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