硼中子俘获疗法临床试验问题与展望  

Problems and prospects of clinical trials of boron neutron capture therapy

作　　者：朱晒红[1] 孙许龙[1] 曾一家 宋泽文[1] 雍中 Shaihong Zhu;Xulong Sun;Yijia Zeng;Zewen Song;Zhong Yong(The Third Xiangya Hospital of Central South University,Changsha 410012,China)

机构地区：[1]中南大学湘雅三医院,长沙410012

出　　处：《科学通报》2022年第14期1490-1497,共8页Chinese Science Bulletin

摘　　要：硼中子俘获疗法(boron neutron capture therapy,BNCT)指^(10)B俘获热中子裂变的产物杀灭肿瘤细胞的二元靶向细胞内放疗技术.中国于2014年开展BNCT的临床试验,其中早期恶性黑色素瘤2例,随访5年均成活;晚期患者17例,其中8例辐照后局部肿瘤缩小但生存期无延长,9例患者肿瘤组织内^(10)B未达到治疗所需浓度而无法辐照.首次试验明确了医院内中子照射器(IHNI-1)及^(10)B药物的安全性,并验证了其治疗效果.针对发现的问题,我们认为,应将转移性肿瘤、复发瘤及放化疗不敏感的晚期肿瘤作为BNCT核心适应证,以此为目标开展高靶向效率^(10)B药物研发,以高靶向效率^(10)B药物驱动辐照数学模型探索,以辐照数学模型驱动大面积或全身辐照中子源的迭代升级,最终回归临床验证.Boron neutron capture therapy(BNCT)is an intracellular radiotherapy that exploits the neutron capture and fission reaction of the boron isotope, ^(10)B.As a binary targeted tumor therapy based on intracellular radiotherapy,BNCT brings new hope to cancer patients.In 2012,the team from the Third Xiangya Hospital of Central South University,together with Prof.Yongmao Zhou’s team,started the clinical trial of BNCT in China based on the in-hospital neutron irradiator-1(IHNI-1),and completed the first trial of BNCT in September 2014.The following is the summarization of the clinical trial:The first patient,a 53 years old man with black plaque found on the left anterior palmar 7 years ago,was diagnosed as malignant melanoma after pathological examination.The patient completed boron phenylalanine(BPA)drug uptake test and neutron irradiation in September 2014.After irradiation,no tumor tissue was indicated by PET-CT and pathological examination.The team continued to complete drug uptake tests and/or neutron irradiation for a total of 20 cases,including 2 cases of early malignant melanoma,who survived in the 5 years of follow-up.The rest 17 patients were in advanced cancer stage,among which 8 patients had local tumor shrinkage and 9 patients were not suitable for irradiation because ^(10)B in tumor tissue did not reach the required concentration for treatment.The trial validated the safety of IHNI-1 and boron-containing agent,and the anti-tumor effects of BNCT.However,the board application of BNCT is limited by the lack of targeted boron delivery agent.Currently available boron-containing agents cannot concentrate in tumor lesions of some patients at an early stage,resulting in the impracticable status of BNCT for these patients.Even though some difference was observed in the concentration of ^(10)B between tumor and normal tissues in some cancer patients at an advanced stage,the difference is not large enough for in the safe application of total body irradiation by IHNI-1.On the other hand,patients at advanced stage can

关 键 词：硼中子俘获治疗 靶向药物 医院内中子照射器 恶性肿瘤 恶性黑色瘤 

分 类 号：R730.55[医药卫生—肿瘤]