Boron Neutron Capture Therapy : Toward Clinical Trials of Glioma Treatment

The European Collaboration on Boron Neutron Capture Therapy (BNCT), conceived in 1987 and successful in 1989 in gaining financial support as a Concerted Action through the Medical and Health Research Programme of the Commission ofthe European Communities (CEC) in Brussels, considered it an opportune moment to hold its annual Plenary Meeting on 18-20 Septem­ ber 1991 as an International Workshop entitled "Towards Clinical Trials of Glioma with BNCT". The background to this consideration was influenced by the world-wide resurgence ofinterest in NCT over the last 2 decades and by the exemplifica­ tions at the Fourth International Symposium on Neutron Capture Therapy for Cancer held in Sydney in December 1990, where it was strongly indicated that within the next 2 years clinical trials would be started both in Europe and the United States. In particular at the High Flux Reactor of the Joint Research Centre of the CEC at Petten in The Netherlands, an epithermal neutron beam designed and installed in the summer of 1990 recently became operable at full reactor power. An extensive series ofexperiments, including the nuclear and radiobiological characterisation of the beam and a healthy tissue tolerance study on canines has started and has the aim to define the preconditions for clinical trials onpatients with Grade III/IV glioma. However, as with any other new therapy modality, it must be demon­ strated that BNCT is safe for the patient and has a reasonable chance of being an effective therapy. Front Matter....Pages i-ix Opening Speech....Pages 1-3 Welcome Address....Pages 5-6 Safety and Efficacy in Boron Neutron Capture Therapy....Pages 7-13 Some Aspects of BNCT Research at the Brookhaven National Laboratory....Pages 15-22 INEL BNCT Program Directions with Respect to Clinical Trials of BNCT....Pages 23-27 The Department of Energy Research Program in Boron Neutron Capture Therapy....Pages 29-31 Current Overview on the Approach of Clinical Trials at Petten....Pages 33-46 Review of the Physics Calculations Performed for the BNCT Facility at the HFR Petten....Pages 47-58 From Filter Installation to Beam Characterization....Pages 59-77 Neutron Spectrometry Measurements of the Petten HFR, HB11 Neutron Beam....Pages 79-91 A Semi-Empirical Method of Treatment Planning for Boron Neutron Capture Therapy....Pages 93-100 Present Status of the Three-Dimensional Treatment Planning Methodologies for the Petten BNCT Facility....Pages 101-109 A Phase 1 Biodistribution Study of p-Boronophenylalanine....Pages 111-121 RBE in Normal Tissue Studies....Pages 123-128 Treatment Planning and Optimization for Pion Therapy....Pages 129-141 Dose Calculations Based on Image Reconstructions....Pages 143-154 Borocaptate Sodium (BSH) Pharmacokinetics in Glioma Patients....Pages 155-162 BSH in Patients with Malignant Glioma: Distribution in Tissues, Comparison Between BSH Concentration and Histology....Pages 163-174 Macroscopic and Microscopic Biodistribution of BSH in a Rat Glioma Model....Pages 175-178 Healthy Tissue Tolerance Studies for BNCT at the High Flux Reactor in Petten — First Results....Pages 179-188 Cellular Pharmacokinetics of BNCT Compounds and their Cellular Localization with EELS/ESI....Pages 189-195 Large Animal Model Studies of Normal Tissue Tolerance Using an Epithermal Neutron Beam and Borocaptate Sodium....Pages 197-209 Proposal for Patient Selection Criteria and Follow-Up for BNCT in Patients with Supratentorial Malignant Gliomas....Pages 211-218 A Proposal for Phase I Clinical Trials of Glioma Patients....Pages 219-221 Approaches to the Design and Evaluation of Compounds for BNCT....Pages 223-230 The Implementation Strategy for BNCT Trials in Australia....Pages 231-242 Round Table Discussion Approach to Clinical Trials of Glioma....Pages 243-263 Back Matter....Pages 265-279 Proceedings of an international workshop and plenary meeting entitled Towards Clinical Trials of Glioma with Boron Neutron Capture Therapy, held September 18-20, 1991, in Petten, The Netherlands