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Boron neutron capture therapy for malignant brain tumors

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Abstract

Background

Boron neutron capture therapy (BNCT) is tumor-selective particle radiation therapy that depends on the nuclear capture and fission reactions. These reactions occur when a non-radioactive boron isotope (10B) is irradiated with low-energy thermal neutrons to yield high linear energy transfer α-particles and lithium-7 nuclei within a limited path length, i.e., an almost one-cell diameter. The 10B-containing cells can then be selectively destroyed by these potent particles. BNCT has been applied in the field of malignant brain tumors for newly diagnosed and recurrent malignant gliomas (chiefly glioblastomas).

Clinical results

These clinical applications of BNCT have been performed with reactor-based neutron sources over the past decades. We also applied reactor-based BNCT for 58 newly diagnosed glioblastomas and 68 recurrent malignant gliomas including 52 glioblastomas. In this review article, we summarize the clinical results from the literature concerning BNCT for these high-grade gliomas (including our research). We also applied reactor-based BNCT for 46 cases of recurrent and refractory high-grade meningiomas, and some of the results will be presented herein.

Future prospects

In Japan, neutron sources have been shifted from reactors to accelerators. Phase 1 and 2 clinical trials have been performed for recurrent malignant gliomas using accelerator-based neutron sources, and now fortunately, a cyclotron-based neutron generator has been approved as a medical device by Japanese regulatory authority, as the world’s first accelerator-based BNCT system for medical use. We also discuss the future prospects of accelerator-based BNCT in hospitals as therapy for malignant brain tumors.

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Acknowledgements

Authors appreciate Dr. Shinji Kawabata for his activity to participate in clinical research and trial as sub investigator in Osaka Medical College. We express thanks for Prof. Hiroki Tanaka, Institute for integrated Radiation and Nuclear Science, Kyoto University and Prof. Kazuki Tsuchida, Research Laboratory of Accelerator-based BNCT System, Graduate School of Engineering, Nagoya University for fruitful discussion regarding accelerator for BNCT. Also we express thanks for Dr. Toshinori Mitsumoto, Sumitomo Heavy Industry, Ltd., for preparation of schematic diagram of accelerator in Fig. 

Fig. 5
figure 5

Left: A photograph of a cyclotron-based accelerator for neutron generation installed in the Kansai BNCT Medical Center in Osaka Medical College. Right: Cross-sectional diagram of the accelerator-based neutron source. By courtesy of Sumitomo Heavy Industries, Ltd., Shinagawa-ku, Tokyo

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  1. Kansai BNCT Medical Center, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan

    Shin-Ichi Miyatake, Masahiko Wanibuchi, Naonori Hu & Koji Ono

  2. Department of Neurosurgery, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan

    Shin-Ichi Miyatake & Masahiko Wanibuchi

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  1. Shin-Ichi Miyatake
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Miyatake, SI., Wanibuchi, M., Hu, N. et al. Boron neutron capture therapy for malignant brain tumors. J Neurooncol 149, 1–11 (2020). https://doi.org/10.1007/s11060-020-03586-6

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