硼中子俘获治疗头颈部肿瘤临床试验进展

Progress in clinical trials of boron neutron capture therapy of head and neck cancers

硼中子俘获治疗(boron neutron capture therapy,BNCT)是结合靶向治疗和重离子治疗的先进二元放疗技术。其原理是利用含有10B同位素的硼药在肿瘤细胞中靶向聚集,随后中子束流外部照射肿瘤部位,发生10B(n,α)7Li核反应,释放出杀伤范围为一个细胞大小(5~9μm)的高传能线密度α粒子和7Li粒子杀死肿瘤细胞。BNCT具有精准的肿瘤靶向性,对正常组织损伤小,分割次数(1~3次)少于传统放疗(30次)等优点。BNCT使用的中子由反应堆或加速器产生,临床使用的硼药包括BPA和BSH两种。本文介绍国内外开展的头颈部肿瘤BNCT临床试验及取得的重要进展。BNCT对于头颈部肿瘤治疗具有良好疗效。随着加速器中子源的推广应用和新型硼药的研发,BNCT将会在临床放射治疗领域发挥更大的作用。

Boron neutron capture therapy(BNCT)is an advanced radiotherapy combined with targeted therapy and heavy ion therapy.BNCT is based on the nuclear reaction 10B(n,α)7Li that occurs when boron-10 isotopes is irradiated with neutrons of the appropriate energy to produce high-energy recoiling 7Li nuclei andαparticles.The released high linear energy transfer(LET)particles have path lengths of approximately one cell diameter(5-9μm)and deposit most of their energy within the boron-containing tumor cells.BNCT has the advantages of precise tumor targeting,less damage to normal tissue and fewer irradiation fractionations(1-3 fractionations)than conventional radiotherapy(30 fractionation).The neutrons used in BNCT are produced by reactors or accelerators.The boron drugs used in clinical trials include BPA and BSH.In this paper,we review the clinical trial status and the significant progress of BNCT for head and neck tumors.The clinical data have approved the effectiveness of BNCT in the treatment of head and neck cancer.With the technical improvement of accelerator neutron source and the development of new boron drugs,BNCT will play a more important role in the field of clinical radiotherapy in the future.