Current status of boron neutron capture therapy of high grade gliomas and recurrent head and neck cancer

Radiation Oncology

Shinji Kawabata⁴  Itsuro Kato⁷  Teruhito Aihara⁸  Minoru Suzuki²  Franz M Wagner⁶  Peter J Binns¹  Kent J Riley^1,10  WS Kiger⁵  Otto K Harling^1,11  M Graca H Vicente⁹  Rolf F Barth³ 

[1] Department of Radiation Oncology, Mt. Auburn Hospital, Cambridge, MA, 02138, USA;Particle Radiation Oncology Research Center, Kyoto University, Osaka, Japan;Department of Pathology, The Ohio State University, 165 Hamilton Hall, 1645 Neil Avenue, Columbus, OH, 43210, USA;Department of Neurosurgery, Osaka Medical College, Takatsuki City, Osaka, Japan;Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA;Forschungs-Neutronenquelle Heinz Maier-Leibnitz (FRM II), Technische Universität München, Garching, Germany;Department of Oral and Maxillofacial Surgery II, Graduate School of Dentistry, Osaka University, Osaka, Japan;Department of Otolaryngology and Head and Neck Surgery, Kawasaki Medical School, Okayama, Japan;Department of Chemistry, Louisiana State University, Baton Rouge, LA, 70803, USA;Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, 02114, USA;Department of Nuclear Science & Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA

关键词: Radiation therapy;    Head and neck cancer;    Gliomas;    Boron neutron capture therapy;   

Others  :  1155372
DOI  :  10.1186/1748-717X-7-146

 received in 2012-06-14, accepted in 2012-07-23,  发布年份 2012

【 摘 要 】

Boron neutron capture therapy (BNCT) is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Clinical interest in BNCT has focused primarily on the treatment of high grade gliomas, recurrent cancers of the head and neck region and either primary or metastatic melanoma. Neutron sources for BNCT currently have been limited to specially modified nuclear reactors, which are or until the recent Japanese natural disaster, were available in Japan, the United States, Finland and several other European countries, Argentina and Taiwan. Accelerators producing epithermal neutron beams also could be used for BNCT and these are being developed in several countries. It is anticipated that the first Japanese accelerator will be available for therapeutic use in 2013. The major hurdle for the design and synthesis of boron delivery agents has been the requirement for selective tumor targeting to achieve boron concentrations in the range of 20 μg/g. This would be sufficient to deliver therapeutic doses of radiation with minimal normal tissue toxicity. Two boron drugs have been used clinically, a dihydroxyboryl derivative of phenylalanine, referred to as boronophenylalanine or “BPA”, and sodium borocaptate or “BSH” (Na₂B₁₂H₁₁SH). In this report we will provide an overview of other boron delivery agents that currently are under evaluation, neutron sources in use or under development for BNCT, clinical dosimetry, treatment planning, and finally a summary of previous and on-going clinical studies for high grade gliomas and recurrent tumors of the head and neck region. Promising results have been obtained with both groups of patients but these outcomes must be more rigorously evaluated in larger, possibly randomized clinical trials. Finally, we will summarize the critical issues that must be addressed if BNCT is to become a more widely established clinical modality for the treatment of those malignancies for which there currently are no good treatment options.

【 授权许可】

   
2012 Barth et al.; licensee BioMed Central Ltd.

【 图 表 】

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