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Global clinical experience with Boron neutron capture therapy

Gales N. Laurentia, Anghel M. Rodica
Abstract: Boron neutron capture therapy (BNCT) represents a top therapeutic method that relies on knowledge in the area of nuclear technology as well as on medicine experience in treating malignant tumour. Various pre-clinical experiments have been initially applied in order to demonstrate the effectiveness of BNCT concept. Once they demonstrated the concept, pre-clinical experiments continued by focusing on a better establishment of the irradiation parameters in each facility, in view of acquiring dosimetry systems, a treatment plan and, most importantly, the development of boron compounds that fit, as best as possible, the ideal BNCT requirements. The first clinical trials focusing on Boron neutron capture therapy were initiated by Dr. Sweet şi Brownell (Massachusetts Institute of Technology - MIT Boston) and Farr (Brookhaven National Laboratory – BNL) in 1951. Between 1951 and 1961, patients with glioblastoma from USA were irradiated, both at BNL as well as MIT. Based on the support provided by EORTC the first BNCT clinical studies were also initiated in Europe. Consequently, EORTC formed a study group for BNCT. A first phase I trial included 25 patients with optimally operated glioblastomas in 5 neurosurgery centres. Another EORTC protocol studied BSH and BPA administration in patients with different types of solid tumours in order to identify new targets for BNCT. Simultaneously, another study following BNCT and BPA in cutaneous metastases of malignant melanoma was implemented. A fourth protocol was initiated for BNCT with BSH in glioblastoma multifome. A third tumour type approached through BNCT was recurrent head and neck cancer. The first studies were established by Kato in Japan. In September 2003, Hiratsuka treated a recurrent papillary thyroid cancer with BNCT, in Japan. Yanagie and collaborators also used BNCT in Japan in recurrent rectal cancers. Other BNCT experiments evaluated treatment methods for locally recurrent breast cancers. Multiple liver metastases of the colorectal adenocarcinoma were among thy first liver tumours that raised researchers’ interest, from the area of BNCT. In February 2005, in Kyoto, Japan, at KUR the first patient with hepatocarcinoma was treated with BNC. The project “Study, research and application in the oncological clinical practice of treatment with neutron capture by B-10” participated in 2005 at the CEEX governmental competition- “Research Excellency Programmes”. The project was selected for financing and benefitted from a grant offered by the Romanian Government, PC-D01-PT11-94 - 2005.Although there are still considerable inconveniences, BNCT may be regarded as a promising method for cancer treatment.

Keywords: radiotherapy, BNCT, clinical applications


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