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• W2607802547 abstract "Boron neutron capture therapy (BNCT) provides a way to selectively destroy malignant cells and spare normal cells. It is based on the nuclear capture and fission reactions that occur when boron-10, which is a nonradioactive constituent of natural elemental boron, is irradiated with low-energy thermal neutrons to yield high LET and high RBE alpha particles and recoiling lithium-7 nuclei. Since the high LET particles have limited path lengths in tissue (5-9 μm), the destructive effects of these particles are limited to boron-containing cells. Most adequate target cancer cells should be infiltrative, like malignant gliomas which are difficult to be controlled by other par1icles. In addition, this cell selectivity has the merit especially in re-irradiation. For successful BNCT, a sufficient amount of 10B must be selectively delivered to the tumor cells. Prior to neutron irradiation, we can simulate 10B uptake by PET imaging. Since January 2002, we applied BNCT for malignant brain tumors. As of May 2014, we have applied reactor-based BNCT for 58 cases of newly diagnosed GBM, 50 cases of recurrent malignant gliomas, 32 cases of recurrent high-grade meningiomas, and so on, totally 148 cases with 167 times BNCT. At first we applied BNCT for recurrent malignant gliomas (rMG). To evaluate this benefit in the low and high risk group of rMG, We adopted the recursive partitioning analysis (RPA) classification for rMG advocated by Carson et al. in a 2007 article in the Journal of Clinical Oncology (JCO), BNCT could prolong the survival of rMG, especially for high risk group markedly. For example, JCO’s original data set showed the MST for high risk group of rMG (class 3+7) was 4.4 months while our BNCT showed the MST as 11 months. As to rMG, all cases received full-dose radiation therapy, prior to BNCT, therefore radiation necrosis was inevitable even after tumor-selective particle radiation, BNCT. Therefore, we applied anti-VEGF antibody, bevacizumab aggressively for the treatment of symptomatic radiation necrosis after BNCT especially for the recurrent cases who had already treated by other radiation modality. This treatment contributed to further improvement of patient survival of recurrent malignant gliomas after BNCT. Also BNCT showed complete or partial response for all high-grade meningiomas. Depending on these experiences of reactor-based BNCT, we started a phase I clinical trial using both new boron compound (BPA) and a new neutron generator, cyclotron-based accelerator, for rMG since 2012. This study was aimed for the safety and tolerability of this treatment. The clinical trial enrolment and observation were finished with a favorable result. Now we are doing a phase II clinical trial for recurrent GBM using the same combination to clarify the effectiveness. In this presentation, let me introduce the protocol and interim analysis of these trials." @default.
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• W2607802547 date "2017-04-01" @default.
• W2607802547 modified "2023-09-30" @default.
• W2607802547 title "P17.10 BNCT for the treatment of malignant brain tumors, from reactor to accelerator" @default.
• W2607802547 doi "https://doi.org/10.1093/neuonc/nox036.456" @default.
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