The Boron Neutron Capture Therapy Center Begins Treating Overseas Patients
On February 14th the melodious strains of the fourth movement of Mahler's Fifth Symphony were heard for some 20 minutes inside the nuclear reactor at NTHU—for this is the favorite piece of music of an European woman who was here to undergo boron neutron capture therapy (BNCT) for a malignant brain tumor. This was her second treatment, and her first treatment had reduced the glioblastoma deep in her brainstem from 3.51 cm to 1.06 cm. She was accompanied by her husband, and they are hopeful that the second course of treatment will completely eliminate the cancer cells.
NTHU has the only research reactor in Taiwan. In cooperation with the Taipei Veterans General Hospital (TVGH), the reactor was converted for use in BNCT, and now provides treatment for brain, head, and neck cancer. To date, the treatment has provided a new lease on life to over 130 cancer patients from around the world.
The head of NTHU’s BNCT research program is Prof. Chou Fong-in. According to Chou, BNCT is a kind of target radiation therapy in which the patient is first injected with a boron-containing drug; once the drug has accumulated in the tumor, the neutron beam of the nuclear reactor is used to irradiate the tumor, and the high-energy particles generated by the boron neutron capture reaction effectively kill off the tumor cells, without damaging nearby normal cells. Thus BNCT is well suited for treating diffuse cancers and cases in which surgery is contraindicated.
As explained by TVGH oncologist Chen Yi-wei, boron-10 drug contains the structure like essential amino acids , and cancer cells need lots of nutrients to support their abnormal proliferation. Thus cancerous cells absorb almost all the boron-10 before the normal cells have a chance to. The boron acts as a kind of explosive charge, and once the cancerous cells have got their fill of it, the neutron beam is used to “detonate” the charge, killing off the cancer cells.
As it turns out, the husband of the European patient is a physician. He said that his wife used to be an avid tennis player, but four years ago she unexpectedly saw two balls flying towards her at the same time, a classic symptom of diplopia. At first, they thought it was a problem with her eyes, but computer tomography later revealed a low-grade glioma in her brain, located deep inside her brainstem, making it difficult to remove using surgery. After undergoing two craniotomies with gamma knife radiotherapy, the glioma reappeared and had turned malignant. On the advice of a friend, they inquired about the treatment being offered at the TVGH.
Chen arranged for her to come to Taiwan in October 2019, and a positron tomography examination at TVGH confirmed that BNCT could be used to treat her condition. In January of this year she had her first treatment at NTHU’s Boron Neutron Capture Therapy Center.
According to Chen, who undertook special training at Kyoto University in Japan to learn the latest BNCT procedures, the key requirements for BNCT are a boron-containing drug suitable for absorption by cancer cells, and a stable neutron source. NTHU’s research reactor provides a very stable neutron source and is easy to adjust, even better than the accelerators developed in Japan for use in hospitals. Since Japan does not currently accept foreign patients, Taiwan has stepped in to fill the gap.
Lee Min, dean of the College of Nuclear Science and the director of the Boron Neutron Capture Therapy Center, indicated that, since 2010 the Center and TVGH have been jointly conducting clinical trials and emergency medical treatment, and that more than 130 patients with head, neck, or brain cancer have already been treated, most of whom only required a single exposure.
NTHU and the Taoyuan City Government are planning to jointly develop a medical complex as part of the Taoyuan Aerotropolis to be built next to the Taoyuan Airport. According to Lee, BNCT will play a major role at the new facility, and will be used to treat both Taiwanese and overseas patients. The Boron Neutron Capture Therapy Center is also working on the use of BNCT to treat liver cancer, and plans are afoot to establish cooperative relationships with additional hospitals and physicians.
The BNCT treatment mechanism.
The Patient’s husband wrote down the music that his wife would like to listen to during her treatment.