Yanagie Hironobu, Maruyama Syoji, Oyama Kazuyuki, Ono Yasuo, Kuroyama Shinichi, Nonaka Yasumasa, Hatae Ryo, Furuya Yoshitaka, Suzuki Minoru, Masunaga Shin-Ichiro, Sakurai Yoshinori, Kondo Natsuko, Tanaka Hiroki, Maruhashi Akira, Ono Koji, Sugihara Takumichi, Takahashi Hiroyuki
Department of Surgery, Shin-Yamate Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan;
Department of Gastrointestinal Surgery, Keiaikai Kojin Hospital, Iwate, Japan.
In Vivo. 2025 May-Jun;39(3):1470-1491. doi: 10.21873/invivo.13948.
BACKGROUND/AIM: Boron neutron capture therapy (BNCT) is a novel treatment that induces targeted tumor cell damage through the selective accumulation of B compounds in cancer cells followed by the production of alpha and lithium particles using thermal neutron irradiation. Despite its potential, clinical applications of BNCT for recurrent gastrointestinal cancers remain limited. This study presents the first pilot clinical evaluation of BNCT using intravenous boronophenylalanine (BPA) for such cancers.
Four patients with recurrent gastrointestinal cancers were enrolled in this phase I-II clinical study. All had tumors refractory to standard treatments, including surgery, chemotherapy, and radiotherapy. BNCT was performed using thermal neutron irradiation at Kyoto University Research Reactor. BPA was administered intravenously at 400 mg/kg, and no severe adverse effects were observed. Tumor responses varied, with one patient achieving partial response and three demonstrating stable disease at three months post-treatment. Notably, BNCT alleviated cancer-related symptoms, such as pain and nerve compression, improving patients' quality of life. Dosimetric evaluations confirmed effective tumor doses with acceptable exposure to surrounding normal tissues.
BNCT is a promising modality for recurrent gastrointestinal cancers, offering symptom relief and potential antitumor effects. Its safety and feasibility were demonstrated in this study. Future research should explore fractionated BNCT and combination therapies with immunotherapy or targeted agents to enhance efficacy further.
背景/目的：硼中子俘获疗法（BNCT）是一种新型治疗方法，通过硼化合物在癌细胞中的选择性积累，随后利用热中子辐照产生α粒子和锂粒子，从而诱导靶向肿瘤细胞损伤。尽管具有潜力，但BNCT在复发性胃肠道癌症的临床应用仍然有限。本研究首次对使用静脉注射硼苯丙氨酸（BPA）治疗此类癌症的BNCT进行了初步临床评估。
四名复发性胃肠道癌症患者参加了这项I-II期临床研究。所有患者的肿瘤对包括手术、化疗和放疗在内的标准治疗均耐药。BNCT在京都大学研究反应堆使用热中子辐照进行。以400mg/kg的剂量静脉注射BPA，未观察到严重不良反应。肿瘤反应各不相同，一名患者达到部分缓解，三名患者在治疗后三个月病情稳定。值得注意的是，BNCT缓解了癌症相关症状，如疼痛和神经压迫，提高了患者的生活质量。剂量学评估证实肿瘤获得了有效剂量，同时周围正常组织的受照剂量可接受。
BNCT是复发性胃肠道癌症的一种有前景的治疗方式，可缓解症状并具有潜在的抗肿瘤作用。本研究证明了其安全性和可行性。未来的研究应探索分次BNCT以及与免疫疗法或靶向药物的联合治疗，以进一步提高疗效。
