Skip to main content

05.06.2019 | Invited Review Article

Boron neutron capture therapy (BNCT): a unique role in radiotherapy with a view to entering the accelerator-based BNCT era

verfasst von: Minoru Suzuki

Erschienen in: International Journal of Clinical Oncology

Einloggen, um Zugang zu erhalten

Abstract

Boron neutron capture therapy (BNCT) has a unique property of tumor-cell-selective heavy-particle irradiation. BNCT can form large dose gradients between cancer cells and normal cells, even if the two types of cells are mingled at the tumor margin. This property makes it possible for BNCT to be used for pre-irradiated locally recurrent tumors. Shallow-seated, locally recurrent lesions have been treated with BNCT because of the poor penetration of neutrons in the human body. BNCT has been used in clinical studies for recurrent malignant gliomas and head and neck cancers using neutron beams derived from research reactors, although further investigation is warranted because of the small number of patients. In the latter part of this review, the development of accelerator-based neutron sources is described. BNCT for common cancers will become available at medical institutes that are equipped with an accelerator-based BNCT system. Multiple metastatic lung tumors have been investigated as one of the new treatment candidates because BNCT can deliver curative doses of radiation to the tumors while sparing normal lung tissue. Further basic and clinical studies are needed to move toward an era of accelerator-based BNCT when more patients suffering from refractory cancers will be treated.
Literatur
1.
Zurück zum Zitat Locher GL (1936) Biological effects and therapeutic possibilities of neutron. Am J Roentgenol Radium Ther 36:1–13 Locher GL (1936) Biological effects and therapeutic possibilities of neutron. Am J Roentgenol Radium Ther 36:1–13
2.
Zurück zum Zitat Coderre JA, Morris GM (1999) The radiation biology of boron neutron capture therapy. Radiat Res 151:1–18PubMed Coderre JA, Morris GM (1999) The radiation biology of boron neutron capture therapy. Radiat Res 151:1–18PubMed
3.
Zurück zum Zitat Soloway AH, Hatanaka H, Davis MA (1967) Penetration of brain and brain tumor. VII. Tumor-binding sulfhydryl boron compound. J Neurosurg 9:200–209 Soloway AH, Hatanaka H, Davis MA (1967) Penetration of brain and brain tumor. VII. Tumor-binding sulfhydryl boron compound. J Neurosurg 9:200–209
4.
Zurück zum Zitat Hatanaka HA (1975) Revised boron-neutron capture therapy for malignant brain tumors. J. Neurol 209:81–94PubMed Hatanaka HA (1975) Revised boron-neutron capture therapy for malignant brain tumors. J. Neurol 209:81–94PubMed
5.
Zurück zum Zitat Mishima Y, Honda C, Ichikawa M et al (1989) Treatment of malignant melanoma by single thermal neutron capture therapy with melanoma-seeking 10b-compound. Lancet 334:388–389 Mishima Y, Honda C, Ichikawa M et al (1989) Treatment of malignant melanoma by single thermal neutron capture therapy with melanoma-seeking 10b-compound. Lancet 334:388–389
6.
Zurück zum Zitat Wongthai P, Hagiwara K, Miyoshi Y et al (2015) Boronophenylalanine, a boron delivery agent for boron neutron capture therapy, is transported by ATB0,+, LAT1 and LAT2. Cancer Sci 106:279–286PubMedPubMedCentral Wongthai P, Hagiwara K, Miyoshi Y et al (2015) Boronophenylalanine, a boron delivery agent for boron neutron capture therapy, is transported by ATB0,+, LAT1 and LAT2. Cancer Sci 106:279–286PubMedPubMedCentral
7.
Zurück zum Zitat Morris GM, Coderre JA, Hopewell JW et al (1994) Response of the central nervous system to boron neutron capture therapy: evaluation using rat spinaro cord. Radiother Oncol 32:249–255PubMed Morris GM, Coderre JA, Hopewell JW et al (1994) Response of the central nervous system to boron neutron capture therapy: evaluation using rat spinaro cord. Radiother Oncol 32:249–255PubMed
8.
Zurück zum Zitat Hatanaka H, Nakagawa Y (1994) Clinical results of long-surviving brain tumor patients who underwent boron neutron capture therapy. Int J Radiat Oncol Biol Phys 28:1061–1066PubMed Hatanaka H, Nakagawa Y (1994) Clinical results of long-surviving brain tumor patients who underwent boron neutron capture therapy. Int J Radiat Oncol Biol Phys 28:1061–1066PubMed
9.
Zurück zum Zitat Diaz AZ (2003) Assessment of the results from the phase I/II boron neutron capture therapy trials at the Brookhaven National Laboratory from a clinician's point of view. J Neurooncol 62:101–109PubMed Diaz AZ (2003) Assessment of the results from the phase I/II boron neutron capture therapy trials at the Brookhaven National Laboratory from a clinician's point of view. J Neurooncol 62:101–109PubMed
10.
Zurück zum Zitat Busse PM, Harling OK, Palmer MR et al (2003) A clinical examination of the results from the Harvard-MIT NCT program phase I clinical trial of neutron capture therapy for intracranial disease. J Neurooncol 62:111–121PubMed Busse PM, Harling OK, Palmer MR et al (2003) A clinical examination of the results from the Harvard-MIT NCT program phase I clinical trial of neutron capture therapy for intracranial disease. J Neurooncol 62:111–121PubMed
11.
Zurück zum Zitat Vos MJ, Turowski B, Zanella FE et al (2005) Radiologic findings in patients with boron neutron capture therapy for glioblastoma multiforme within EORTC trial 11961. Int J Radiat Oncol Biol Phys 61:392–399PubMed Vos MJ, Turowski B, Zanella FE et al (2005) Radiologic findings in patients with boron neutron capture therapy for glioblastoma multiforme within EORTC trial 11961. Int J Radiat Oncol Biol Phys 61:392–399PubMed
12.
Zurück zum Zitat Kankaanranta L, Seppälä T, Koivunor H et al (2011) L-boronophenylalanine-mediated boron neutron capture therapy for malignant glioma progressing after external beam radiation therapy: a phase I study. Int J Radiat Oncol Biol Phys 80:369–376PubMed Kankaanranta L, Seppälä T, Koivunor H et al (2011) L-boronophenylalanine-mediated boron neutron capture therapy for malignant glioma progressing after external beam radiation therapy: a phase I study. Int J Radiat Oncol Biol Phys 80:369–376PubMed
13.
Zurück zum Zitat Herriksson R, Capala J, Michanek A et al (2008) Boron neutron capture therapy (BNCT) for glioblastoma multiforme: a phase II study evaluating a prolonged high-dose of bornophenylalanine (BPA). Radiother Oncol 88:183–191 Herriksson R, Capala J, Michanek A et al (2008) Boron neutron capture therapy (BNCT) for glioblastoma multiforme: a phase II study evaluating a prolonged high-dose of bornophenylalanine (BPA). Radiother Oncol 88:183–191
14.
Zurück zum Zitat Pelettier L, H-Stenstam B, Rezaei A et al (2008) An investigation of boron neutron capture therapy for recurrent glioblastoma multiforme. Acta Neurol Scand 117:191–197 Pelettier L, H-Stenstam B, Rezaei A et al (2008) An investigation of boron neutron capture therapy for recurrent glioblastoma multiforme. Acta Neurol Scand 117:191–197
15.
Zurück zum Zitat Yamamoto T, Matsumura A, Nakai K et al (2004) Current clinical results of the Tsukuba BNCT trial. Appl Radiat Isot 61:1089–1093PubMed Yamamoto T, Matsumura A, Nakai K et al (2004) Current clinical results of the Tsukuba BNCT trial. Appl Radiat Isot 61:1089–1093PubMed
16.
Zurück zum Zitat Yamamoto T, Nakai K, Kageji T et al (2009) Boron neutron capture therapy for newly diagnosed glioblastoma. Radiother Oncol 91:80–84PubMed Yamamoto T, Nakai K, Kageji T et al (2009) Boron neutron capture therapy for newly diagnosed glioblastoma. Radiother Oncol 91:80–84PubMed
17.
Zurück zum Zitat Kageji T, Nagahiro S, Matsuzaki K et al (2006) Boron neutron capture therapy using mixed epithermal and thermal neutron beams in patients with malignant glioma-correlation between radiation dose and radiation injury and clinical outcome. Int J Radiat Oncol Biol Phys 65:1446–1455PubMed Kageji T, Nagahiro S, Matsuzaki K et al (2006) Boron neutron capture therapy using mixed epithermal and thermal neutron beams in patients with malignant glioma-correlation between radiation dose and radiation injury and clinical outcome. Int J Radiat Oncol Biol Phys 65:1446–1455PubMed
18.
Zurück zum Zitat Kageji T, Mizobuchi Y, Nagahiro S et al (2011) Clinical results of boron neutron capture therapy (BNCT) for glioblastoma. Appl Radiat Isot 69:1823–1825PubMed Kageji T, Mizobuchi Y, Nagahiro S et al (2011) Clinical results of boron neutron capture therapy (BNCT) for glioblastoma. Appl Radiat Isot 69:1823–1825PubMed
19.
Zurück zum Zitat Kageji T, Mizobuchi Y, Nagahiro S et al (2011) Long-survivors of glioblastoma treated with boron neutron capture therapy (BNCT). Appl Radiat Isot 69:1800–1802PubMed Kageji T, Mizobuchi Y, Nagahiro S et al (2011) Long-survivors of glioblastoma treated with boron neutron capture therapy (BNCT). Appl Radiat Isot 69:1800–1802PubMed
20.
Zurück zum Zitat Miyatake S, Kawabata S, Kuroiwa T et al (2005) Modified boron neutron capture therapy for malignant gliomas performed using epithermal neutron and two boron compounds with different accumulation mechanisms: an efficacy study based on findings on neuroimages. J Neurosurg 103:1000–1009PubMed Miyatake S, Kawabata S, Kuroiwa T et al (2005) Modified boron neutron capture therapy for malignant gliomas performed using epithermal neutron and two boron compounds with different accumulation mechanisms: an efficacy study based on findings on neuroimages. J Neurosurg 103:1000–1009PubMed
21.
Zurück zum Zitat Kawabata S, Miyatake S, Kuroiwa T et al (2009) Boron neutron capture therapy for newly diagnosed glioblastoma. J Radiat Res (Tokyo) 50:51–60 Kawabata S, Miyatake S, Kuroiwa T et al (2009) Boron neutron capture therapy for newly diagnosed glioblastoma. J Radiat Res (Tokyo) 50:51–60
22.
Zurück zum Zitat Miyatake S, Kawabata S, Yokoyama K et al (2009) Survival benefit of boron neutron capture therapy for recurrent malignant gliomas. J Neurooncol 91:199–206PubMed Miyatake S, Kawabata S, Yokoyama K et al (2009) Survival benefit of boron neutron capture therapy for recurrent malignant gliomas. J Neurooncol 91:199–206PubMed
23.
Zurück zum Zitat Kawabata S, Miyatake S, Hiramatsu R et al (2011) Phase II clinical study of boron neutron capture therapy combined with X-ray radiotherapy/temozolomide in patients with newly diagnosed glioblastoma multifomre-study design and current status report. Appl Radiat Isot 69:1796–1799PubMed Kawabata S, Miyatake S, Hiramatsu R et al (2011) Phase II clinical study of boron neutron capture therapy combined with X-ray radiotherapy/temozolomide in patients with newly diagnosed glioblastoma multifomre-study design and current status report. Appl Radiat Isot 69:1796–1799PubMed
24.
Zurück zum Zitat Yamamoto T, Nakai K, Nariai T et al (2011) The status of Tsukuba BNCT trial: BPA-based boron neutron capture therapy combined with X-ray irradiation. Appl Radiat Isot 69:1817–1818PubMed Yamamoto T, Nakai K, Nariai T et al (2011) The status of Tsukuba BNCT trial: BPA-based boron neutron capture therapy combined with X-ray irradiation. Appl Radiat Isot 69:1817–1818PubMed
25.
Zurück zum Zitat Nakai K, Yamamoto T, Aiyama H et al (2011) Boron neutron capture therapy combined with fractionated photon irradiation for glioblastoma: a recursive partitioning analysis of BNCT patients. Appl Radiat Isot 69:1790–1792PubMed Nakai K, Yamamoto T, Aiyama H et al (2011) Boron neutron capture therapy combined with fractionated photon irradiation for glioblastoma: a recursive partitioning analysis of BNCT patients. Appl Radiat Isot 69:1790–1792PubMed
26.
Zurück zum Zitat Shiba H, Takeuchi K, Hiramatsu R et al (2018) Boron neutron capture therapy combined with early successive bevacizumab treatment for recurrent malignant gliomas—a pilot study. Neurol Med Chir (Tokyo) 58:487–494 Shiba H, Takeuchi K, Hiramatsu R et al (2018) Boron neutron capture therapy combined with early successive bevacizumab treatment for recurrent malignant gliomas—a pilot study. Neurol Med Chir (Tokyo) 58:487–494
27.
Zurück zum Zitat Miyatake SI, Kawabata S, Hiramatsu R et al (2018) Boron neutron capture therapy of malignant gliomas. Prog Neural Surg 32:48–56 Miyatake SI, Kawabata S, Hiramatsu R et al (2018) Boron neutron capture therapy of malignant gliomas. Prog Neural Surg 32:48–56
28.
Zurück zum Zitat Kondo N, Barth RF, Miyatake SI et al (2017) Cerebrospinal fluid dissemination of high-grade glioma following boron neutron capture therapy occurs more frequently in the small cell subtype of IDH1R132H mutation-negative glioblastoma. J Neurooncol 133:107–118PubMedPubMedCentral Kondo N, Barth RF, Miyatake SI et al (2017) Cerebrospinal fluid dissemination of high-grade glioma following boron neutron capture therapy occurs more frequently in the small cell subtype of IDH1R132H mutation-negative glioblastoma. J Neurooncol 133:107–118PubMedPubMedCentral
29.
Zurück zum Zitat Kato I, Ono K, Sakurai Y et al (2004) Effectiveness of BNCT for recurrent head and neck malignancies. Appl Radiat Isot 61:1069–1073PubMed Kato I, Ono K, Sakurai Y et al (2004) Effectiveness of BNCT for recurrent head and neck malignancies. Appl Radiat Isot 61:1069–1073PubMed
30.
Zurück zum Zitat Ariyoshi Y, Miyatake S, Kimura Y et al (2007) Boron neutron capture therapy using epithemal neutrons for recurrent cancer in the oral cavity and cervical lymph node metastasis. Oncol Rep 18:861–866PubMed Ariyoshi Y, Miyatake S, Kimura Y et al (2007) Boron neutron capture therapy using epithemal neutrons for recurrent cancer in the oral cavity and cervical lymph node metastasis. Oncol Rep 18:861–866PubMed
31.
Zurück zum Zitat Kimura Y, Ariyoshi Y, Miyatake S et al (2009) Boron neutron capture therapy for papillary cystadenocarcinoma in the upper lip: a case report. Appl Radiat Isot 67:S47–S49PubMed Kimura Y, Ariyoshi Y, Miyatake S et al (2009) Boron neutron capture therapy for papillary cystadenocarcinoma in the upper lip: a case report. Appl Radiat Isot 67:S47–S49PubMed
32.
Zurück zum Zitat Suzuki M, Sakurai Y, Nagata K et al (2006) Impact of intra-arterial administration of boron compounds on dose-volume histograms in boron neutron capture therapy for recurrent head-and-neck tumors. Int J Radiat Oncol Biol Phys 66:1523–1527PubMed Suzuki M, Sakurai Y, Nagata K et al (2006) Impact of intra-arterial administration of boron compounds on dose-volume histograms in boron neutron capture therapy for recurrent head-and-neck tumors. Int J Radiat Oncol Biol Phys 66:1523–1527PubMed
33.
Zurück zum Zitat Fuwa N, Suzuki M, Sakurai Y et al (2008) Treatment results of boron neutron capture therapy using intra-arterial administration of boron compounds for recurrent head and neck cancer. Br J Radiol 81:749–752PubMed Fuwa N, Suzuki M, Sakurai Y et al (2008) Treatment results of boron neutron capture therapy using intra-arterial administration of boron compounds for recurrent head and neck cancer. Br J Radiol 81:749–752PubMed
34.
Zurück zum Zitat Kankaanranta L, Saarilahti K, Mäkitie A et al (2011) Boron neutron capture therapy (BNCT) followed by intensity modulated chemoradiotherapy as primary treatment of large head and neck cancer with intracranial involvement. Radiother Oncol 99:98–99PubMed Kankaanranta L, Saarilahti K, Mäkitie A et al (2011) Boron neutron capture therapy (BNCT) followed by intensity modulated chemoradiotherapy as primary treatment of large head and neck cancer with intracranial involvement. Radiother Oncol 99:98–99PubMed
35.
Zurück zum Zitat Wang LW, Wang SI, Chu PY et al (2011) BNCT for locally recurrent head and neck cancer: preliminary clinical experience from a phase I/II trial at Tsing Hua open-pool reactor. Appl Radiat Isot 69:1803–1806PubMed Wang LW, Wang SI, Chu PY et al (2011) BNCT for locally recurrent head and neck cancer: preliminary clinical experience from a phase I/II trial at Tsing Hua open-pool reactor. Appl Radiat Isot 69:1803–1806PubMed
36.
Zurück zum Zitat Kankaanranta L, Seppälä T, Koivunoro H et al (2012) Boron neutron capture therapy in the treatment of locally recurred head and neck cancer: final analysis of a phase I/II traial. Int J Radiat Oncol Biol Phys 82:e67–75PubMed Kankaanranta L, Seppälä T, Koivunoro H et al (2012) Boron neutron capture therapy in the treatment of locally recurred head and neck cancer: final analysis of a phase I/II traial. Int J Radiat Oncol Biol Phys 82:e67–75PubMed
37.
Zurück zum Zitat Suzuki M, Kato I, Aihara T et al (2014) Boron neutron capture therapy outcomes for advanced or recurrent head and neck cancer. J Radiat Res 55:146–153PubMed Suzuki M, Kato I, Aihara T et al (2014) Boron neutron capture therapy outcomes for advanced or recurrent head and neck cancer. J Radiat Res 55:146–153PubMed
38.
Zurück zum Zitat Aihara T, Morita N, Kamitani N et al (2014) BNCT for advanced or recurrent head and neck cancer. Appl Radiat Isot 88:12–15PubMed Aihara T, Morita N, Kamitani N et al (2014) BNCT for advanced or recurrent head and neck cancer. Appl Radiat Isot 88:12–15PubMed
39.
Zurück zum Zitat Aihara T, Hiratsuka J, Ishikawa H et al (2015) Fatal carotid blowout syndrome after BNCT for head and neck cancers. Appl Radiat Isot 88:202–206 Aihara T, Hiratsuka J, Ishikawa H et al (2015) Fatal carotid blowout syndrome after BNCT for head and neck cancers. Appl Radiat Isot 88:202–206
40.
Zurück zum Zitat Wang LW, Chen YW, Ho CY et al (2014) Fractionated BNCT for locally recurrent head and neck cancer: experience from a phase I/II clinical trial at Tsing Hua open-pool reactor. Appl Radiat Isot 88:64–68 Wang LW, Chen YW, Ho CY et al (2014) Fractionated BNCT for locally recurrent head and neck cancer: experience from a phase I/II clinical trial at Tsing Hua open-pool reactor. Appl Radiat Isot 88:64–68
43.
Zurück zum Zitat Tanaka H, Sakurai Y, Suzuki M et al (2009) Characteristics comparison between a cyclotron-based neutron source and KUR-HWNIF for boron neutron capture therapy. Nucl Instrum Methods Phys Res B 267:1970–1977 Tanaka H, Sakurai Y, Suzuki M et al (2009) Characteristics comparison between a cyclotron-based neutron source and KUR-HWNIF for boron neutron capture therapy. Nucl Instrum Methods Phys Res B 267:1970–1977
44.
Zurück zum Zitat Tanaka H, Sakurai Y, Suzuki M et al (2009) Improvement of dose distribution in phantom by using epithermal neutron source based on the Be(p, n) reaction using a 30 MeV proton cyclotron accelerator. Appl Radiat Isot 67:S258–261PubMed Tanaka H, Sakurai Y, Suzuki M et al (2009) Improvement of dose distribution in phantom by using epithermal neutron source based on the Be(p, n) reaction using a 30 MeV proton cyclotron accelerator. Appl Radiat Isot 67:S258–261PubMed
45.
Zurück zum Zitat Tanaka H, Sakurai Y, Suzuki M et al (2011) Experimental verification of beam characteristics for cyclotron-based epithermal neutron source (C-BENS). Appl Radiat Isot 69:1642–1645PubMed Tanaka H, Sakurai Y, Suzuki M et al (2011) Experimental verification of beam characteristics for cyclotron-based epithermal neutron source (C-BENS). Appl Radiat Isot 69:1642–1645PubMed
46.
Zurück zum Zitat Falías RO, Bortolussi S, Menéndez PR et al (2014) Exploring boron neutron capture therapy for non-small cell lung cancer. Phys Med 30:888–897 Falías RO, Bortolussi S, Menéndez PR et al (2014) Exploring boron neutron capture therapy for non-small cell lung cancer. Phys Med 30:888–897
47.
Zurück zum Zitat Farías RO, Garabalino MA, Ferraris S et al (2015) Toward a clinical application of ex situ boron neutron capture therapy for lung tumors at the RA-3 reactor in Argentina. Med Phys 42:4161–4173PubMed Farías RO, Garabalino MA, Ferraris S et al (2015) Toward a clinical application of ex situ boron neutron capture therapy for lung tumors at the RA-3 reactor in Argentina. Med Phys 42:4161–4173PubMed
48.
Zurück zum Zitat Suzuki M, Endo K, Satoh H et al (2008) A novel concept of treatment of treatment of diffuse or multiple pleural tumors by boron neutron capture therapy (BNCT). Radiother Oncol 88:192–195PubMed Suzuki M, Endo K, Satoh H et al (2008) A novel concept of treatment of treatment of diffuse or multiple pleural tumors by boron neutron capture therapy (BNCT). Radiother Oncol 88:192–195PubMed
Metadaten
Titel
Boron neutron capture therapy (BNCT): a unique role in radiotherapy with a view to entering the accelerator-based BNCT era
verfasst von
Minoru Suzuki
Publikationsdatum
05.06.2019
Verlag
Springer Singapore
Erschienen in
International Journal of Clinical Oncology
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-019-01480-4

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.