Boron Neutron Capture Therapy for Malignant Brain Tumors

• Published in: Neurologia medico-chirurgica Vol. 56; no. 7; pp. 361 - 371
• Main Authors: MIYATAKE, Shin-Ichi, KAWABATA, Shinji, HIRAMATSU, Ryo, KUROIWA, Toshihiko, SUZUKI, Minoru, KONDO, Natsuko, ONO, Koji
• Format: Journal Article
• Language: English
• Published: Japan The Japan Neurosurgical Society 01.01.2016; THE JAPAN NEUROSURGICAL SOCIETY
• Subjects: Boron Neutron Capture Therapy; Brain Neoplasms - diagnosis; Brain Neoplasms - radiotherapy; Brain Neoplasms - therapy; glioblastoma; high-grade meningioma; Humans; malignant glioma; positron emission tomography; Review
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/nmc.ra.2015-0297

Boron neutron capture therapy (BNCT) is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Therefore, BNCT enables the application of a high dose of particle radiation selectively to tumor cells in which boron-10 compound has been accumulated. We applied BNCT using nuclear reactors for 167 cases of malignant brain tumors, including recurrent malignant gliomas, newly diagnosed malignant gliomas, and recurrent high-grade meningiomas from January 2002 to May 2014. Here, we review the principle and history of BNCT. In addition, we introduce fluoride-18-labeled boronophenylalanine positron emission tomography and the clinical results of BNCT for the above-mentioned malignant brain tumors. Finally, we discuss the recent development of accelerators producing epithermal neutron beams. This development could provide an alternative to the current use of specially modified nuclear reactors as a neutron source, and could allow BNCT to be performed in a hospital setting.