A Case Report of Using Salvage Boron Neutron Capture Therapy (BNCT) to Improve a Recurrent Hypopharyngeal Cancer Patient

Abstract

硼中子俘获治疗是一项二元性的肿瘤治疗方式，主要原理是先透过注射含硼-10的药物入患者体内，待其肿瘤吸收后，再施以热中子照射肿瘤区块，后续的裂解反应会产生两个高生物效应的肿瘤破坏性粒子：α粒子以及锂核。这些高能量释放的粒子不但能有效破坏肿瘤细胞的双股螺旋DNA，且其由于影响范围小，对于周边正常组织亦有安全保护的效果。本次主要报告一位77岁来自上海的男性患者，其罹患巨大复发性下咽癌，经反复性各式治疗失败后，后续尝试透过硼中子俘获治疗来提供补救性的处置。由于复发肿瘤包覆右颈动脉，本团队首先提供其右颈动脉血管保护性支架处置，后转介前往清华大学原子反应堆硼中子癌病治疗中心进行治疗安排，患者首先安排施打含硼-10药物BPA (4-10borophenylalanine; BPA)后并接受热中子照射。执行治疗结束后复发的右颈肿瘤大幅缩小改善，追踪检查的正子检查并呈现无肿瘤活性的反应表现。患者治疗完后无不适身体主诉表示，治疗成果高度表现出这个治疗的优异性，特别适合对于浸润性的肿瘤，可以提供肿瘤患者一个高质量的治疗协助。 Boron Neutron Capture Therapy (BNCT) is a binary cancer treatment. The principal mechanism is to deliver a B-10 containing drug into tumor cells firstly and then irradiate tumor lesion specifically with thermal neutron. The fission reaction will generate two particles, α particle and lithium nucleus, which have high biological effectiveness and will damage tumor cells effectively. These high linear energy transfer (LET) particles can not only destroy double strand DNA of tumor cells but it can also protect adjacent normal tissue because it possesses very short reaction area. This time we are trying to report a 77-year-old Shanghai male patient who suffered from huge recurrent hypopharyngeal cancer. After failure of several kinds of treatments, BNCT was chosen for him as a salvage management. Because the recurrent tumor encased his right carotid artery, our BNCT group first helped him to perform a stentgraft placement to protect his right carotid artery. Then he was referred to cancer center in Tsing-Hua University Open Pool Reactor (THOR) for BNCT management. He underwent B-10 drug (4-10borophenylalanine; BPA) infusion first and then was irradiated by thermal neutron. After BNCT, significant tumor regression was observed. Followed Positron Emission Tomography (PET) scan revealed there was no viability of tumor cells. Patient didn’t have any uncomfortable complaints after BNCT. The treatment results showed outstanding outcomes, especially for the tumors with infiltrating characteristics. It’s really an effective therapy with good post-treatment quality of life.