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硼中子俘获治疗作为癌症治疗方式的现实评价。

A realistic appraisal of boron neutron capture therapy as a cancer treatment modality.

机构信息

Department of Pathology, The Ohio State University, Columbus, OH, 43210, USA.

Beijing Capture Technology Company, Ltd., Beijing, 102445, P. R. China.

出版信息

Cancer Commun (Lond). 2018 Jun 19;38(1):36. doi: 10.1186/s40880-018-0280-5.


DOI:10.1186/s40880-018-0280-5
PMID:29914575
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6006699/
Abstract

Boron neutron capture therapy (BNCT) is a binary therapeutic modality based on the nuclear capture and fission reactions that occur when the stable isotope boron-10 is irradiated with neutrons to produce high-energy alpha particles and recoiling lithium-7 nuclei. In this Commentary we will focus on a number of papers that were presented at a Symposium entitled "Current Clinical Status of Boron Neutron Capture Therapy and Paths to the Future", which was held in September 2017 at the China National Convention Center in Beijing. Results were presented by clinicians from Japan, Finland, the United States, the China mainland and Taiwan, China who have been working in the multiple disciplines that are required for carrying out clinical BNCT. The main focus was on the treatment of patients with malignant brain tumors, recurrent tumors of the head and neck region, and cutaneous melanomas. The results obtained in treating these patients were reported in detail and, although most of the patients with brain tumors and head and neck cancer were not cured, there was evidence of some clinical efficacy. Although there are a number of problems that must be addressed, further clinical studies to evaluate the efficacy of BNCT are warranted. First, despite considerable effort by numerous investigators over the past 40 years, there still are only two boron-containing drugs in clinical use, L-boronophenylalanine (BPA) and sodium borocaptate (BSH). Therefore, until new and more effective boron delivery agents are developed, efforts should be directed to improving the dosing and delivery of BPA and BSH. Second, due to a variety of reasons, nuclear reactor-based BNCT has ended except for its use in the China mainland and Taiwan. Therefore, the future of BNCT depends upon the results of the ongoing Phase II clinical trials that are being carried out in Japan and the soon to be initiated trials that will be carried out in Finland. If the results obtained from these clinical trials are sufficiently promising, then BNCT will have a clear path to the future, especially for patients with the therapeutically challenging malignancies that in the past have been treated with reactor-based BNCT.

摘要

硼中子俘获治疗(BNCT)是一种基于二元治疗模式的治疗方法,它基于当稳定同位素硼-10 被中子照射时发生的核俘获和裂变反应,产生高能阿尔法粒子和反冲锂-7 核。在本评论中,我们将重点介绍 2017 年 9 月在北京中国国家会议中心举行的题为“硼中子俘获治疗的当前临床状况和未来发展途径”的专题研讨会的一系列论文。来自日本、芬兰、美国、中国大陆和中国台湾的临床医生介绍了他们在开展临床 BNCT 所需的多个学科中的工作成果。重点是治疗恶性脑肿瘤、头颈部复发性肿瘤和皮肤黑色素瘤患者。详细报告了这些患者的治疗结果,尽管大多数脑肿瘤和头颈部癌症患者没有治愈,但有一些临床疗效的证据。尽管存在许多必须解决的问题,但进一步的临床研究评估 BNCT 的疗效是必要的。首先,尽管过去 40 年来许多研究人员做出了巨大努力,但临床应用的含硼药物仅有两种,即 L-硼苯丙氨酸(BPA)和硼替佐米(BSH)。因此,在开发出新的、更有效的硼递药剂之前,应努力改进 BPA 和 BSH 的剂量和给药。其次,由于各种原因,除中国大陆和台湾地区仍在使用核反应堆 BNCT 外,基于核反应堆的 BNCT 已经结束。因此,BNCT 的未来取决于正在日本进行的 II 期临床试验和即将在芬兰开始的临床试验的结果。如果这些临床试验的结果足够有前景,那么 BNCT 将有明确的未来发展方向,特别是对于过去用反应堆 BNCT 治疗的具有治疗挑战性的恶性肿瘤患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e10/6006699/defac3940739/40880_2018_280_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e10/6006699/defac3940739/40880_2018_280_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e10/6006699/defac3940739/40880_2018_280_Fig1_HTML.jpg

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本文引用的文献

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Clinical trials for treating recurrent head and neck cancer with boron neutron capture therapy using the Tsing-Hua Open Pool Reactor.

Cancer Commun (Lond). 2018-6-19

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Cancer Commun (Lond). 2018-6-19

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J Neurooncol. 2017-5

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