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
Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei City 112304, Taiwan.
Department of Oncology, Taipei Veterans General Hospital, Taipei City 11217, Taiwan.
Life (Basel). 2022 Apr 10;12(4):566. doi: 10.3390/life12040566.
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.
脑干肿瘤是起源于中脑、脑桥和延髓的异质性恶性胶质瘤肿瘤，在儿童中相对常见，占所有小儿脑肿瘤的10%至20%。然而，尽管采用化疗和放疗进行积极治疗，侵袭性脑干胶质瘤的预后仍然极差。这意味着有许多危及生命的患者已用尽所有可用的治疗方案，开始面临生命末期阶段。因此，硼中子俘获疗法（BNCT）这种高选择性重粒子照射的独特特性可能非常适合延长晚期脑干胶质瘤患者的生命。在此，我们报告了一系列符合紧急和同情使用条件的晚期脑干胶质瘤危及生命的患者病例，我们对他们实施了每次低治疗剂量的预定两次分割挽救性BNCT策略。没有患者经历与BNCT相关的急性或晚期不良事件。有3例患者在两次分割BNCT治疗后复发，其特点是年龄较小、T/N比值较低且接受的治疗剂量较低。因此，两次分割低剂量BNCT可能是晚期脑干肿瘤的一种有前景的治疗方法。对于T/N比值低的年轻患者，应考虑更多次分割的低剂量BNCT。
