Development of Cell Selective particle irradiation using epithermal neutron beam for malignant brain tumor.

8例经组织学证实的胶质母细胞瘤患者，平均年龄65岁(男：女=2：6，32~76岁)，采用BNCT后加30GyX射线照射的新方案行BNCF。7例术前行BNCT治疗。15例中5例存活，术后平均随访20.3个月。进展时间11.9个月，总生存期25.3个月。不良反应(3~GT；级)2例，惊厥、脑肿胀1例，一过性动眼神经麻痹1例。为了估计组织中硼化合物的绝对浓度，用质子磁共振波谱(MRS)对苯丙氨酸和L-对硼苯丙氨酸进行了定量。我们可以识别几个特征共振，峰在7.32ppm(苯丙氨酸)，四个峰在7.1ppm到7.6ppm(BPA)。使用水模体，以组织水信号为内标，通过质子磁共振波谱获得绝对浓度。基于MRS计算的浓度与已知浓度之间具有较高的相关性。(r=0.99：苯丙氨酸和双酚A)。这些临床结果似乎令人鼓舞，但侵袭性肿瘤细胞的有效性仍不清楚。改进的肿瘤靶向、硼输送和中子分布将提高BNCT的治疗效果。磁共振波谱结果表明，质子MRS可以作为BNCT中BPA定量的非侵入性和潜在有用的技术。

Clinical trial of BNCT for GlioblastomaEight patients with histological proven glioblastoma with an average age of 65 years (range 32-76, M:F=2:6) were underwent BNCF with new protocol which add 30Gy X ray irradiation after BNCT. 7 patients were treated with intra-operative BNCT before the protocol. In these 15 cases, 5 cases are alive; the average post BNCT follow up period was 20.3 months. Time to progression was 11.9 months, overall survival was 25.3 months. Adverse event (Grade 3>) were seen in 2 cases; convulsion and brain swelling (1 case) and transient oculomotor palsy (1 case). These result superior to standard treatments and suggest the effectiveness of the BNCT for malignant gliomaMR spectroscopyFor estimating absolute concentration of boron compounds in tissue, proton MR spectroscopy (MRS) was applied to quantify phenylalanine and L-p-boronophenylalanine (BPA). We could identify several characteristic resonances, peak of 7.32ppm (phenylalanine), four peak ranged 7.1 ppm to 7.6 ppm (BPA). A water phantom were used, and absolute concentration were obtained by proton MRS using a tissue water signal as an internal standards. These methods have high correlation between the calculated concentrations based on MRS and the known concentration. (R=0.99: phenylalanine and BPA).These clinical results appear to encouraging, but the effectiveness of the invading tumor cells are still unclear. Improved tumor targeting boron delivery and neutron distribution will enhance the therapeutic effectiveness of BNCT.MR spectroscopy results indicate that proton MRS can be non-invasive and potentially useful technique for BPA quantification in BNCT.