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Boron Neutron Capture Therapy (BNCT) 硼中子捕獲治療

Boron Neutron Capture Therapy (BNCT) is a unique form of treatment that utilizes a nuclear reaction between boron-10 and neutrons to selectively destroy tumor cells. The process begins by administering a boron-containing compound to the patient, which preferentially accumulates in tumor cells. The tumor is then irradiated with low-energy neutrons. When the neutrons interact with the boron-10 atoms within the tumor, a nuclear reaction occurs, releasing high-energy particles (lithium-7 and alpha particles) with extremely short penetration ranges, which selectively destroy the tumor cells.

Advantages

The alpha particles and lithium-7 ions generated by BNCT have an extremely short range—only about 5 to 9 micrometers, which is less than the diameter of a typical tumor cell (10 to 20 micrometers). Ideally, this means the damage is confined to the tumor cells, causing minimal harm to surrounding healthy tissue. In addition, alpha particles have a higher Relative Biological Effectiveness (RBE) than photons, making BNCT potentially more effective against radioresistant tumorsCurrently, only a few thousand BNCT treatments have been performed worldwide. 

BNCT may be suitable for the following cases:

  1. Radioresistant malignant tumors:
    Such as malignant gliomas and melanomas. Similar to heavy particle therapy, the alpha particles produced in BNCT have a high RBE, potentially offering greater therapeutic benefits for tumors resistant to conventional radiation.

  2. Recurrent tumors:
    Including recurrent malignant brain tumors, head and neck cancers, skin cancers, and pediatric tumors. When traditional treatments have failed, BNCT can sometimes yield remarkably positive results.

A Successful Case Of Malignant Glioma 惡性腦膠質母細胞瘤案例

Taiwan and Japan are currently the only two countries in the world offering Boron Neutron Capture Therapy (BNCT) for cancer treatment. The BNCT Center at National Tsing Hua University (NTHU) is the world's only team currently treating brain cancer with this cutting-edge technology. NTHU recently announced that Swiss author Lars Jaeger traveled to Taiwan at the end of July to receive treatment for a malignant brain tumor. After the treatment, Jaeger shared that he experienced no discomfort during BNCT, saying it felt like "a peaceful 30-minute nap."

Swiss Author Undergoes BNCT at NTHU: "Like a 30-Minute Nap"

According to NTHU, Jaeger was diagnosed with glioblastoma multiforme (GBM) four years ago. Despite undergoing five craniotomies, Gamma Knife, and even carbon ion therapy, the tumor repeatedly recurred. After two years of researching new treatments and consulting with doctors in Switzerland and Japan, he ultimately chose Taiwan, saying:

"BNCT is my last hope, and NTHU has the most experienced team in the world."

After evaluation and treatment planning by Dr. Yi-Wei Chen, Director of the Particle Therapy Committee of the Taiwan Society for Therapeutic Radiology and Oncology, and radiation oncologist at Taipei Veterans General Hospital, Jaeger underwent a 90-minute intravenous infusion of boron-containing drugs to target diffuse cancer cells in the brain. He was then taken to a treatment room adjacent to the nuclear reactor for a 24-minute neutron beam irradiation.

How BNCT Works

BNCT involves the injection of boron-containing drugs that selectively accumulate in tumor cells. Once the drug has been absorbed by the cancer cells, a neutron beam is used to irradiate the tumor area. The boron atoms undergo nuclear fission, releasing highly destructive alpha particles and lithium nuclei, which self-destruct and kill the tumor cells. Because the boron compound specifically targets cancer cells, normal brain cells remain unaffected.

During the treatment, Jaeger's wife and daughter communicated with him via microphone. After the session, he reported no discomfort, likening it to a short, restful nap. Since BNCT typically requires only one session, Jaeger and his family returned to Switzerland afterward, hopeful for positive results.

BNCT Effective Against Brain and Head & Neck Cancers — Liver Cancer is Next Target

Dr. Tsung-Kuang Yeh, Director of the NTHU Nuclear Science and Technology Development Center, stated that the Tsing Hua Neutron Medical Irradiation System (THOR), developed for BNCT, received Taiwan's first-ever medical device license for this type of treatment in June — also the first globally. This opens the possibility for BNCT to become a routine frontline cancer therapy, bringing new hope to cancer patients worldwide.

Dr. Yeh explained the principle of BNCT, "It's like a Trojan Horse, where boron-containing drugs disguise themselves as sugar-coated poison, infiltrating cancer cells and detonating from within."

Because the destructive radius of the boron reaction is only about the size of a single cell, it avoids damaging nearby healthy tissues — making it ideal for treating diffuse or inoperable tumors, such as brain cancers.

So far, over a thousand patients with brain tumors, head and neck cancers, and melanoma have received BNCT at NTHU in collaboration with Taipei Veterans General Hospital. These patients include hundreds of international cases from the U.S., Australia, Spain, Italy, Switzerland, Japan, Brazil, Singapore, Hong Kong, and China.

Taiwan and Japan remain the only two countries in the world capable of offering BNCT, and NTHU is the only center globally providing BNCT specifically for brain cancer — serving as a final refuge for many terminal brain tumor patients.

BNCT PROCESS治療流程

  • Application Process for Compassionate Use Therapy / IRB After Physician Approval
  • Schedule Axumin PET scan in advance (PET/MR or PET/CT)
  • If necessary, create custom molds to immobilize the body part
  • If required, undergo photon therapy or chemotherapy (e.g., Avastin) beforehand
  • Admit to hospital on the scheduled day and administer boron drug to allow cancer cells to absorb it
  • Proceed to the nuclear reactor for BNCT (Boron Neutron Capture Therapy) irradiation
  • After irradiation, return to the ward for several sessions of immunotherapy, if needed
  • If the effect is insufficient, a second irradiation may be considered