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Objectives: The investigation was designed to explore the efficacy of boron neutron capture therapy (BNCT) as treatment for recurrent intracranial meningeal tumours., Materials and Methods: Three patients with meningeal tumours, recurring after initial surgery, radiation therapy and several reoperations, were evaluated for treatment with BNCT by determination of the accumulation of boronophenylalanine fructose (BPA-F) in tumour and in surrounding tissue. Two of these patients were subsequently treated by BNCT., Results: The present results indicate that BNCT could be effective in prolonging time to recurrence, and thus in extending survival time, for patients with recurrent intracranial meningeal tumours., Conclusions: BNCT is potentially an effective radiation treatment modality for malignant intracranial meningeal tumours, which could increase progression-free survival, thus reducing the need for additional surgical interventions. Indications for BNCT would be even larger if recurrent grade II meningiomas could be treated, as indicated by the results of the boron uptake study.

A boron neutron capture therapy (BNCT) facility has been constructed at Studsvik, Sweden. It includes two filter/moderator configurations. One of the resulting neutron beams has been optimized for clinical irradiations with a filter/moderator system that allows easy variation of the neutron spectrum from the thermal to the epithermal energy range. The other beam has been designed to produce a large uniform field of thermal neutrons for radiobiological research. Scientific operations of the Studsvik BNCT project are overseen by the Scientific Advisory Board comprised of representatives of major universities in Sweden. Furthermore, special task groups for clinical and preclinical studies have been formed to facilitate collaboration with academia. The clinical Phase II trials for glioblastoma are sponsored by the Swedish National Neuro-Oncology Group and, presently, involve a protocol for BNCT treatment of glioblastoma patients who have not received any therapy other than surgery. In this protocol, p-boronophenylalanine (BPA), administered as a 6-h intravenous infusion, is used as the boron delivery agent. As of January 2002, 17 patients were treated. The 6-h infusion of 900 mg BPA/kg body weight was shown to be safe and resulted in the average blood-boron concentration of 24 microg/g (range: 15-32 microg/g) at the time of irradiation (approximately 2-3 h post-infusion). Peak and average weighted radiation doses to the brain were in the ranges of 8.0-15.5 Gy(W) and 3.3-6.1 Gy(W), respectively. So far, no severe BNCT-related acute toxicities have been observed. Due to the short follow-up time, it is too early to evaluate the efficacy of these studies.