Boron neutron capture therapy at the crossroads: Challenges and opportunities

被引:97
作者
Barth, Rolf F. [1 ]
机构
[1] Ohio State Univ, Dept Pathol, Columbus, OH 43210 USA
基金
美国国家卫生研究院;
关键词
New boron delivery agents; Dosimetry; Neutron sources; Randomized clinical trials; New therapeutic approaches; BRAIN-BARRIER DISRUPTION; GLIOMA-BEARING RATS; ENHANCED SURVIVAL; INTRACAROTID INJECTION; INTRACEREBRAL DELIVERY; SODIUM BOROCAPTATE; PHOTON IRRADIATION; TUMORS; COMBINATION; BORONOPHENYLALANINE;
D O I
10.1016/j.apradiso.2009.03.102
中图分类号
O61 [无机化学];
学科分类号
070301 ; 081704 ;
摘要
Over the past 25 years research on boron neutron capture therapy (BNCT) has progressed relatively slowly but steadily with the greatest progress in the field of clinical studies. These specifically have included the use of BNCT to treat a variety of malignancies other than high grade gliomas and melanomas. However, there are a number of key areas where little, if any, significant progress has been made. First and foremost among these has been the lack of new boron delivery agents. Improvement in drug delivery and the development of the best dosing paradigms for both boronophenylalanine (BPA) and sodium borocaptate (BSH) are of major importance and these still have not been optimized. Dosimetry for BNCT is still imprecise and is based on treating to normal tissue tolerance, based on blood boron values, rather than any real-time information on the boron content of the residual tumor that is to be irradiated. Another major problem has been the total dependence on nuclear reactors as neutron sources for BNCT. However, this will change in the near future when a clinically useful accelerator comes into use in 2009. Like it or not, in order to gain the credibility of a broad community of physicians who treat brain tumor patients, there will have to be a randomized clinical trial. Finally, BNCT will have to compete with new therapeutic approaches that are less costly and more effective for the treatment of brain tumors. These challenges notwithstanding, BNCT can fill an important niche for those malignancies, whether primary or recurrent, for which there is currently no effective therapy. (C) 2009 Elsevier Ltd. All rights reserved.
引用
收藏
页码:S3 / S6
页数:4
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