Radiation Oncology/Neutrons

Neutron Therapy

By Disease Site

• General Head & Neck
• Salivary Glands

Overview

• Initial use of neutrons for clinical treatment occurred 1936-1943, but resulted in significant late effects
• By 1960's, radiobiology of neutrons was better understood, and a cyclotron was constructed at the Hammersmith Hospital in London. In USA, physics-lab based devices were used for initial pilot trials.
• In 1984, University of Washington commissioned a high-energy neutron generator for clinical beam delivery, with NCI funding
• Neutrons can be delivered via several modalities
  • External beam neutron therapy
  • Boron-neutron capture therapy (BNCT)
  • Neutron brachytherapy via Californium-252
• Most clinical trials were inconclusive, and enthusiasm about neutrons as a treatment modality waned

Boron Neutron Capture Therapy (BNCT)

• FBPA (4-borono-2-(18) F-fluoro-phenylalanin) PET imaging
  • Kohei Hanaoka et al. EJNMMI Res. 2014. FBPA PET in boron neutron capture therapy for cancer: prediction of (10)B concentration in the tumor and normal tissue in a rat xenograft model (PMID: 25621196)
  • L Menichetti et al. Appl Radiat Isot. 2009 Jul. Positron emission tomography and [18F]BPA: a perspective application to assess tumour extraction of boron in BNCT (PMID: 19410471)
• Accelerator-Based BNCT (AB-BNCT) vs. Reactor-Based BNCT (RB-BNCT)
  • Minoru Suzuki et al. Radiother Oncol. 2009 Jul. Impact of accelerator-based boron neutron capture therapy (AB-BNCT) on the treatment of multiple liver tumors and malignant pleural mesothelioma (PMID: 19329206)
• Tsing Hua open-pool reactor (THOR)
  • C J Tung et al. Appl Radiat Isot. 2004 Nov. Characteristics of the new THOR epithermal neutron beam for BNCT (PMID: 15308158)
  • Ling-Wei Wang et al. Cancer Commun (Lond). 2018. Clinical trials for treating recurrent head and neck cancer with boron neutron capture therapy using the Tsing-Hua Open Pool Reactor (PMID: 29914577)
• Proton Accelerator based Boron Neutron Capture Therapy (A-BNCT) facility in Korea
  • Eunjoong Lee et al. Appl Radiat Isot. 2018 Dec. Radiation safety analysis for the A-BNCT facility in Korea (PMID: 30273764)
• Boron neutron capture therapy (BNCT) in Finland
  • Sauli Savolainen et al. Phys Med. 2013 May. Boron neutron capture therapy (BNCT) in Finland: technological and physical prospects after 20 years of experiences (PMID: 22613369)
• Treatment Planning System
  • Tzung-Yi Lin et al. Development and verification of THORplan--a BNCT treatment planning system for THOR. Appl Radiat Isot. 2011 Dec;69(12):1878-81. (PMID: 21497101)
  • Naonori Hu et al. Evaluation of a treatment planning system developed for clinical boron neutron capture therapy and validation against an independent Monte Carlo dose calculation system. Radiat Oncol. 2021 Dec 24;16(1):243. (PMID: 34952608)