Clinical Aspects of Neutron Capture Therapy

Since Locher first suggested Boron Neutron Capture Therapy (BNCT) in 1936, this theoretically ideal system has intrigued investigators. Unfortunately, the first clinical trials between 1951-1961 were not successful. However, they served to implant firmly the seed of BNCT, the growth of which has been carefully nurtured at a number of locations world-wide. This fact is attested to by the ongoing clinical trials in Japan as well as by the presence of researchers from active groups in the ten countries represented at this Workshop. In 1983 and 1985, the first and second international biannual symposia on BNCT were held, in response to a resurgence of interest in this field. In 1986, the DOE sponsored a workshop on NCT, in large part directed toward evaluating the national effort and the various neutron sources available within the United States. It now seems likely, because of various factors including improved neutron beams and boron delivery systems which have made the modality more attractive, that clinical trials will be initiated in the United States within the next few years. This 1988 special workshop, interspersed between the biannual international symposia, represents an effort to seek ideas and advice on the clinical a~pects of BNCT, from all those diverse groups with a national commitment to this project. Our purpose is to facilitate our endeavor to incorporate the best procedures and techniques in the upcoming clinical trials.

Table of Contents:
Dose Rate and Therapeutic Gain.- Swine Skin: A Model to Evaluate Dose Recovery from Different Radiations.- Neutron Capture Therapy in Support of Other Radiation Treatment.- Research on Neutron Capture Therapy in the USSR.- BNCT Project in Czechoslovakia.- Proposed Clinical Trial Studying the Pharmacokinetics of B.S H.- Fractionation in Boron Neutron Capture Therapy.- Dose Fractionation in Neutron Capture Therapy for Malignant Melanoma.- Thermal Neutron Capture Therapy: The Japanese-Australian Clinical Trial for Malignant Melanoma.- BNCT and Dose Fractionation.- Some Thoughts on Tolerance, Dose and Fractionation in Boron Neutron Capture Therapy.- Delayed Effects of Neutron Irradiation on Central Nervous System Microvasculature in the Rat.- Pre-Clinical Studies on Boron Neutron Capture Therapy.- Boron Compounds for Neutron Capture Therapy.- Fractionation Considerations for Boron Neutron Capture Therapy: The Perspective of a Clinician.- Vascular Factors Affecting Drug Delivery to Brain Tumors.- Clinical Considerations in the Use of Thermal and Epithermal Neutron Beams for Neutron Capture Therapy.- A Proposed Protocol for Clinical Trials of Boron Neutron Capture Therapy in Glioblastoma Multiforme.- The Effect of Ionizing Radiation on the Blood-Brain Barrier: Considerations for the Application of Boron Neutron Capture Therapy of Brain Tumors.- Computerized Axial Tomographic and Magnetic Resonance Imaging Scan Follow-up of Two Patients After Boron Neutron Capture Therapy for Glioblastoma Multiforme.- A Stochastic Model for High-LET Response for Boron Neutron Capture Therapy.- Distributions of Sulfhydryl Borane Monomer and Dimer in Rodents and Monomer in Humans: Boron Neutron Capture Therapy of Nelanoma and Glioma in Boronated Rodents.- A Carboranyl Porphyrin for Boron NeutronCapture Therapy of Brain Tumors.- Distribution of a Boronated Porphyrin in Marine Tumors.- Survival Assays with a Boronated Porphyrin as Measured with Hamster V-79 Cells in Culture.- Neutron Capture Therapy for Melanoma.- Tumor-Seeking Compounds for Boron Neutron Capture Therapy Synthesis and Biodistribution.- Boron-11 Magnetic Resonance Imaging and Spectroscopy; Tools for Investigating Pharmacokinetics for Boron Neutron Capture Therapy.- Selective Thermal Neutron Capture Therapy and Diagnosis of Malignant Melanoma: From Basic Studies to First Clinical Treatment.- Workshop Summary of Moderators’ Reports.- Moderator’s Report and Discussions Working Group on Tumor Compound and Compound Delivery Systems.- Working Group on Optimization of Radiation Dose Delivery.- Contributed Papers.- Blood-Brain Barrier Impairment After Irradiation: Implication in Boron Neutron Capture Therapy.- Implications of Genotypic and Microenvironmental Heterogeneity for the Cure of Solid Tumors by Neutron Capture Therapy.- Status Report on the Development of a Spallation Neutron Source for Neutron Capture Therapy.- Uptake of Boron into Human Gliomas of Athymic Mice and into Syngeneic Cerebral Gliomas of Rats After Intracarotid Infusion of Sulfhydryl Boranes.- Toxicities of Na2B12H11SH and Na4B24H22S2 in Mice.- Participants.