Boron neutron capture therapy (BNCT)
Boron Neutron Capture Therapy (BNCT) is an experimental cancer treatment primarily aimed at high-grade gliomas, particularly glioblastoma multiforme (GBM), along with potential applications for other brain tumors and skin melanomas. This method seeks to improve patient outcomes where traditional treatments, such as surgery, radiation, and chemotherapy, often fall short, particularly as GBM tends to infiltrate surrounding brain tissue, making it difficult to treat effectively. The procedure involves administering an intravenous injection of a boron compound that targets tumor cells, followed by exposure to a beam of neutrons generated from a nuclear reactor.
During the treatment, the boron captures the thermal neutrons, leading to a localized reaction that produces energetic particles capable of destroying cancer cells while minimizing damage to nearby healthy tissue. Although BNCT is designed to confine its effects to the tumor area, it has not yet demonstrated a significant advantage over standard therapies in clinical studies. Currently, it remains a subject of ongoing research rather than a widely adopted treatment option, as its effectiveness continues to be evaluated against established cancer treatments. Overall, BNCT represents a hopeful avenue for targeted cancer therapy, especially for challenging cases like GBM.
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Boron neutron capture therapy (BNCT)
Definition: Boron neutron capture therapy (BNCT) is a form of radiation therapy that brings together a stable isotope of boron (boron 10) and a beam of low-energy neutrons to target and destroy tumor cells while leaving adjacent tissue undamaged.
Cancers treated: Glioblastoma multiforme (GBM); perhaps other brain tumors and skin melanomas
Why performed: Treatments for high-grade gliomas are supportive but not curative. More than 30 percent of adult patients with GBM die within twelve months, according to a 2008 Critical Reviews in Oncology/Hematology literature review. Standard approaches using surgical resection, radiation therapy, and chemotherapy increase the median survival time to fifteen months, with 4 percent of patients surviving beyond five years, as reported in Frankly Speaking about Cancer: Brain Tumors (2013). This is the case because tumor cells infiltrate into surrounding brain tissue and are not readily available to the surgeon, and because GBM is typically diagnosed at a more advanced stage than other brain cancers. Researchers hope that BNCT will offer some improvement.
Patient preparation: Patient preparation is standard for radiation therapy. The size and location of the patient’s tumor are determined using imaging studies such as magnetic resonance imaging (MRI) or computed tomography (CT) scans. Prior to neutron targeting, the patient’s skin is marked to position the head correctly.
Steps of the procedure: The patient first receives an intravenous injection of boron 10 that has been chemically tagged to bind with the tumor cells. Neutrons created in a nuclear reactor and modified for BNCT treatment are beamed into the targeted tissue. Neutron activity slows during the ensuing collisions, resulting in a transformation into low-energy thermal neutrons. The boron atoms are then able to capture the thermal neutrons, resulting in boron disintegration into energetic lithium 7 and alpha particles. These cancer-destroying particles react in a very small area, thus confining the ensuing tissue destruction to the tumor.
After the procedure: There are no special procedures following BNCT.
Risks: The risks are minimal because the path length of the boron elements produced during the procedure is small, limiting the destructive properties to the size of a single cell and leaving nontargeted tissue unharmed.
Results: Although work on boron neutron capture therapy continues to hold promise, in general it has proved no more effective than standard therapies and so is not a routine approach to treatment.
Bibliography
Barth, Rolf F., et al. "Boron Neutron Capture Therapy of Brain Tumors: Current Status and Future Prospects." High-Grade Gliomas: Diagnosis and Treatment. Ed. Gene H. Barnett. Totowa: Humana, 2007. Print.
Barth, Rolf F., et al. "Current Status of Boron Neutron Capture Therapy of High Grade Gliomas and Recurrent Head and Neck Cancer." Radiation Oncology 7.146 (2012): n. pag. Web. 9 Sept. 2014.
"Brain and Spinal Tumors: Hope through Research." National Institute of Neurological Disorders and Stroke. Natl. Inst. of Health, 3 June 2014. Web. 9 Sept. 2014.
Brandes, Alba A., et al. "Glioblastoma in Adults." Critical Reviews in Oncology/Hematology. 67.2 (2008): 139–52. Web. 9 Sept. 2014.
National Brain Tumor Society and Cancer Support Community. Frankly Speaking about Cancer: Brain Tumors. Washington: Cancer Support Community, 2013. PDF file.