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两种含硼-10化合物在结直肠癌肝转移灶中的摄取情况,用于硼中子俘获疗法体外照射(欧洲癌症研究与治疗组织试验11001)

Uptake of two 10B-compounds in liver metastases of colorectal adenocarcinoma for extracorporeal irradiation with boron neutron capture therapy (EORTC Trial 11001).

作者信息

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

机构信息

Department of Radiation Oncology, University Duisburg-Essen, Essen, Germany.

出版信息

Int J Cancer. 2008 Mar 1;122(5):1164-71. doi: 10.1002/ijc.23224.

Abstract

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.

摘要

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。

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