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透过补救性硼中子俘获治疗后显着改善复发性下咽癌之个案报告
A Case Report of Using Salvage Boron Neutron Capture Therapy (BNCT) to Improve a Recurrent Hypopharyngeal Cancer Patient

DOI: 10.12677/ACRPO.2019.84005, PP. 29-38

Keywords: 硼中子俘获治疗，下咽癌，诊断治疗，线性能量转换，生活质量
Boron Neutron Capture Therapy, Hypopharyngeal Cancer, Theranostics, Linear Energy Transfer, Quality of Life

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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.
References

[1]  International Atomic Energy Agency (IAEA) Publication (2001) Current Status of Neutron Capture Therapy. IAEA-TECDOC-1223.
https://pub.iaea.org/MTCD/Publications/PDF/te_1223_prn.pdf
[2]  Miyatake, S., Kawa-bata, S., Yokoyama, K., et al. (2008) Survival Benefit of Boron Neutron Capture Therapy for Recurrent Malignant Glio-mas. Journal of Neuro-Oncology, 91, 199-206.
https://doi.org/10.1007/s11060-008-9699-x
[3]  Suzuki, M., Kato, I., Aihara, T., et al. (2014) Boron Neutron Capture Therapy Outcomes for Advanced or Recurrent Head and Neck Cancer. Journal of Radiation Research, 55, 146-153.
https://doi.org/10.1093/jrr/rrt098
[4]  卫生福利部国民健康署(台湾). 2016年癌症登记年报(下咽癌部分) [N].
https://www.hpa.gov.tw/Pages/List.aspx?nodeid=269, 2018-12-27.
[5]  Bonner, J.A., Harari, P.M., Giralt, J., et al. (2006) Radiotherapy plus Cetuximab for Squamous-Cell Carcinoma of the Head and Neck. The New England Journal of Medicine, 354, 567-578.
https://doi.org/10.1056/NEJMoa053422
[6]  Chang, F.C., Lirng, J.F., Luo, C.B., et al. (2008) Patients with Head and Neck Cancers and Associated Postirradiated Carotid Blowout Syndrome: Endovascular Therapeutic Methods and Outcomes. Journal of Vascular Surgery, 47, 936-945.
https://doi.org/10.1016/j.jvs.2007.12.030
[7]  Chang, F.C., Luo, C.B., Lirng, J.F., et al. (2015) Endovascular Management of Post-Irradiated Carotid Blowout Syndrome. PLoS ONE, 10, e0139821.
https://doi.org/10.1371/journal.pone.0139821
[8]  Coderre, J.A., Makar, M.S., Micca, P.L., et al. (1993) Deriva-tions of Relative Biological Effectiveness for the High-LET Radiations Produced during Boron Neutron Capture Irradia-tions of the 9L Rat Gliosarcoma in Vitro and in Vivo. International Journal of Radiation Oncology, Biology, Physics, 27, 1121-1129.
https://doi.org/10.1016/0360-3016(93)90533-2
[9]  Locher, G.L. (1936) Biological Effects and Therapeutical Pos-sibilities of Neutrons. American Journal of Roentgenology and Radium Therapy, 36, 1-13.
[10]  Kreiner, A.J., Bergueiro, J., Cartelli, D., et al. (2016) Present Status of Accelerator-Based BNCT. Reports of Practical Oncology and Radiothera-py, 21, 95-101.
https://doi.org/10.1016/j.rpor.2014.11.004
[11]  Naito, F. (2018) Introduction to Accelerators for Boron Neutron Capture Therapy. Therapeutic Radiology and Oncology, 2, 54.
https://doi.org/10.21037/tro.2018.10.11
[12]  Sweet, W.H. (1951) The Uses of Nuclear Disintegration in the Diag-nosis and Treatment of Brain Tumor. The New England Journal of Medicine, 245, 875-878.
https://doi.org/10.1056/NEJM195112062452301
[13]  Yong, Z., Song, Z.W., Zhou, Y.M., et al. (2016) Boron Neutron Capture Therapy for Malignant Melanoma: First Clinical Case Report in China. Chinese Journal of Cancer Re-search, 28, 634-640.
https://doi.org/10.21147/j.issn.1000-9604.2016.06.10
[14]  Aihara, T., Morita, N., Kamitani, N., et al. (2014) BNCT for Advanced or Recurrent Head and Neck Cancer. Applied Radiation and Isotopes, 88, 12-15.
https://doi.org/10.1016/j.apradiso.2014.04.007
[15]  Sauerwein, W., Wittig, A., Moss, R. and Nakagawa, Y. (2012) Neutron Capture Therapy. Springer, Berlin, 41-54.
https://doi.org/10.1007/978-3-642-31334-9
[16]  Barth, R.F., Vicente, M.G., Harling, O.K., et al. (2012) Current Status of Boron Neutron Capture Therapy of High Grade Gliomas and Recurrent Head and Neck Cancer. Radiation On-cology, 7, 146.
https://doi.org/10.1186/1748-717X-7-146
[17]  Yang, F.Y., Chen, Y.W., Chou, F.I., et al. (2012) Boron Neutron Capture Therapy for Glioblastoma Multiforme: Enhanced Drug Delivery and Antitumor Effect Following Blood-Brain Barrier Disruption Induced by Focused Ultrasound. Future Oncology, 8, 1361-1369.
https://doi.org/10.2217/fon.12.118
[18]  陈一玮, 周凤英, 小野公二, 等. 硼中子捕获肿瘤治疗之原理及现况[J]. 临床医学月刊(台湾), 2010, 66: 341-348.
[19]  Lin, K.H., Chen, Y.W., Lee, R.C., et al. (2019) Nuclear Theranostics in Taiwan. Nuclear Medicine and Molecular Imaging, 53, 86-91.
https://doi.org/10.1007/s13139-019-00576-z
[20]  Watabe, T., Ikeda, H., Nagamori, S., et al. (2017) 18F-FBPA as a Tumor-Specific Probe of L-Type Amino Acid Transporter 1 (LAT1): A Comparison Study with 18F-FDG and 11C-Methionine PET. European Journal of Nuclear Medicine and Molecular Imaging, 44, 321-331.
https://doi.org/10.1007/s00259-016-3487-1

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