Feasibility of boron neutron capture therapy for malignant spinal tumors
Feasibility of boron neutron capture therapy for malignant spinal tumors
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DOI：
10.1016/j.apradiso.2009.03.089
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发表时间：
2009-07-01
影响因子：
1.6
通讯作者：
Matsumura, Akira
中科院分区：
文献类型：
--
作者：
Nakai, Kei;Kumada, Hiroaki;Matsumura, Akira
恶性脊髓肿瘤的治疗目前是无效的。脊柱的特点是其连续性、体积小和脆弱性：小的神经元损伤可导致严重的生活质量损害。本研究旨在从保护正常脊柱的角度探讨BNCT作为肿瘤选择性荷电粒子治疗脊髓肿瘤的可行性，既往文献报道脊髓对放射性脊髓病的耐受剂量为13. 8 Gy-Eq，在实验动物模型中高达11 Gy-Eq的剂量对脊髓无损伤。我们使用JAEA计算剂量系统（JCDS）治疗计划系统在脊髓肿瘤患者的虚拟模型上计算肿瘤剂量和正常脊髓剂量。本研究使用了硼苯丙氨酸（BPA）。在这些计算中，条件设定如下：肿瘤/正常（T/N）比为3.5，血液硼浓度为12 ppm，肿瘤硼浓度为42 ppm，肿瘤和正常脊髓的相对生物学有效性（RBE）值分别为3.8和1.35。我们研究了如何通过改变射束方向和数目来优化中子照射。在我们的理论示例中，简单的对置双野照射实现了28.0 Gy-Eq作为最小肿瘤剂量和7.3 Gy-Eq作为最大正常脊髓剂量。因此，当达到足够的T/N比时，脊髓肿瘤的BNCT是可行的。本研究支持对脊柱肿瘤患者使用F-BPA PET成像。(C)2009爱思唯尔有限公司版权所有。
Treatment of malignant spinal cord tumors is currently ineffective. The characteristics of the spine are its seriality, small volume, and vulnerability: severe QOL impairment can be brought about by small neuronal damage. The present study aimed to investigate the feasibility of BNCT as a tumor-selective charged particle therapy for spinal cord tumors from the viewpoint of protecting the normal spine.A previous report suggested the tolerance dose of the spinal cord was 13.8 Gy-Eq for radiation myelopathy: a dose as high as 11 Gy-Eq demonstrated no spinal cord damage in an experimental animal model. We calculated the tumor dose and the normal spinal cord dose on a virtual model of a spinal cord tumor patient with a JAEA computational dosimetry system (JCDS) treatment planning system. The present study made use of boronophenylalanine (BPA). In these calculations, conditions were set as follows: tumor/normal (T/N) ratio of 3.5, blood boron concentration of 12 ppm, tumor boron concentration of 42 ppm, and relative biological effectiveness (RBE) values for tumor and normal spinal cord of 3.8 and 1.35, respectively. We examined how to optimize neutron irradiation by changing the beam direction and number.In our theoretical example, simple opposed two-field irradiation achieved 28.0 Gy-Eq as a minimum tumor dose and 7.3 Gy-Eq as a maximum normal spinal dose. The BNCT for the spinal cord tumor was therefore feasible when a sufficient T/N ratio could be achieved. The use of F-BPA PET imaging for spinal tumor patients is supported by this study. (C) 2009 Elsevier Ltd. All rights reserved.