Treatment process

First the patient will have an appointment with a radiation oncology specialist experienced in BNCT at the Department of Oncology, Helsinki University Central Hospital. The eligibility of patient for BNCT will be evaluated and the needed laboratory tests and images, details of the BNCT procedure as well as the possible adverse effects and follow-up will be discussed with the patient.  

BNCT treatment is individually planned for every patient and therefore a magnetic resonance imaging (MRI), and depending on tumour type, also computed tomography (CT) imaging, and sometimes also positron emission tomography (PET) imaging are needed. Based on these images a radiation oncologist and physicist will prepare an individual dose plan which determines the sites to be treated and the amount of radiation to be given.  

When the definite decision of BNCT treatment is made after all needed examinations and imaging, the patient is admitted as an inpatient to a hospital ward at the Department of Oncology the day before BNCT delivery.

Patient positioning for BNCT, which requires a visit to BNCT facility (located 6 km from hospital), will be done the day before BNCT delivery.

The boron carrier substance is administered as a 2-hour infusion into the patient’s peripheral vein in the morning of the treatment day. Blood samples will be collected at every twenty minutes during the infusion from an indwelling cannula to monitor the blood boron concentration. 

When infusion has been completed, the patient and nurses will be transported to the BNCT facility.

At the treatment facility the patient will be positioned for irradiation according to the rehearsed procedure.  The neutron irradiation takes place in the irradiation room and is usually given from two directions. Each one of these two irradiations takes about 15-20 minutes.  Blood boron concentration is measured from a blood sample taken from an indwelling cannula between the two irradiations.

Once neutron irradiation has been completed, the patient is transferred back to the Helsinki University Central Hospital for a follow-up period lasting usually 1 to 3 days.  Instructions for further care and a schedule for follow-up visits are provided at the time when the patient is ready to leave the hospital.