Wittig Andrea, Malago Massimo, Collette Laurence, Huiskamp René, Bührmann Sandra, Nievaart Victor, Kaiser Gernot M, Jöckel Karl-Heinz, Schmid Kurt Werner, Ortmann Uta, Sauerwein Wolfgang A
Department of Radiation Oncology, University Duisburg-Essen, Essen, Germany.
Int J Cancer. 2008 Mar 1;122(5):1164-71. doi: 10.1002/ijc.23224.
Disseminated metastases of colorectal cancer in liver are incurable. The trial EORTC 11001 investigates whether autotransplantation after extracorporeal irradiation of the liver by boron neutron capture therapy (BNCT) might become a curative treatment option because of selective uptake of the compounds sodium mercaptoundecahydro-closo-dodecaborate (BSH) or L-para-boronophenylalanine (BPA). BSH (50 mg/kg bw) or BPA (100 mg/kg bw) were infused into patients who subsequently underwent resection of hepatic metastases. Blood and tissue samples were analyzed forthe (10)B-concentration with prompt gamma ray spectroscopy (PGRS). Three patients received BSH and 3 received BPA. Adverse effects from the boron carriers did not occur. For BSH, the highest (10)B-concentration was observed in liver (31.5 +/- 2.7 microg/g) followed by blood (24.8 +/- 4.7 microg/g) and tumor (23.2 +/- 2.1 microg/g) with a mean (10)B-concentration ratio metastasis/liver of 0.72 +/- 0.07. For BPA, the highest (10)B-concentration was measured in metastases (12.1 +/- 2.2 microg/g) followed by liver (8.5 +/- 0.5 microg/g) and blood (5.8 +/- 0.8 microg/g). As BPA is transported actively into cells, viable, metabolically active cells accumulate exclusively this compound. Consequently, a model is proposed to adjust the values measured by PGRS for the proportion of viable cells to express the relevant (10)B-concentration in the tumor cells, revealing a (10)B-concentration ratio metastasis/liver of 6.8 +/- 1.7. In conclusion, BSH is not suitable as (10)B-carrier in liver metastases as the (10)B-concentration in liver was higher compared to metastasis. BPA accumulates in hepatic metastases to an extent that allows for extracorporeal irradiation of the liver with BNCT.
结直肠癌肝转移播散是无法治愈的。欧洲癌症研究与治疗组织(EORTC)11001试验研究了硼中子俘获疗法(BNCT)体外照射肝脏后进行自体移植是否可能成为一种治愈性治疗选择,因为巯基十一氢十二硼酸二钠(BSH)或L-对硼苯丙氨酸(BPA)化合物具有选择性摄取特性。将BSH(50mg/kg体重)或BPA(100mg/kg体重)注入患者体内,随后对患者进行肝转移灶切除术。采用瞬发γ射线能谱法(PGRS)分析血液和组织样本中的硼-10浓度。3例患者接受了BSH,3例接受了BPA。未出现硼载体的不良反应。对于BSH,肝脏中观察到的硼-10浓度最高(31.5±2.7μg/g),其次是血液(24.8±4.7μg/g)和肿瘤(23.2±2.1μg/g),转移灶/肝脏的平均硼-10浓度比为0.72±0.07。对于BPA,转移灶中测得的硼-10浓度最高(12.1±2.2μg/g),其次是肝脏(8.5±0.5μg/g)和血液(5.8±0.8μg/g)。由于BPA被主动转运到细胞内,有活力的、代谢活跃的细胞会特异性地积累这种化合物。因此,提出了一个模型,根据活细胞比例调整PGRS测量值,以表达肿瘤细胞中相关的硼-10浓度,结果显示转移灶/肝脏的硼-10浓度比为6.8±1.7。总之,BSH不适合作为肝转移灶的硼-10载体,因为肝脏中的硼-10浓度高于转移灶。BPA在肝转移灶中积累的程度使得可以用BNCT对肝脏进行体外照射。