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Opening a New Page in the Treatment of Liver Cancer
"It is possible to eliminate liver tumors by internal targeted radiotherapy without using chemotherapy or surgery!" A research team headed by Prof. Fong-In Chou of the Nuclear Science and Technology Development Center at NTHU has developed a new treatment for liver cancer using boron neutron capture therapy (BNCT). In this treatment, the patient is injected with an aqueous solution of boric acid (BA), and then undergoes neutron irradiation for 30 minutes. Two fractions of BA-BNCT treatment can successfully eliminate tumors, without affecting normal liver cell function.
 
The results of the relevant research have been published in international journals, and patented in Taiwan and the United States. This new BA-BNCT technology has been transferred to the Taiwan Biotech Company, which will carry out clinical trials.
 
Prof. Chou has conducted a long-term investigation on the radiation biological effects of BNCT. In 2010, NTHU signed a tripartite cooperation agreement with Kyoto University and the Taipei Veterans General Hospital to use BNCT for cancer patients. In 2014, the research team carried out the two-fraction BNCT on 17 patients who were suffering from recurrent head and neck cancers, and succeeded in improving the condition and quality of life for each patient. Most surprisingly, in six patients, the tumor completely disappeared.
 
The research team then began to use BNCT to treat liver cancer. "BNCT is an internal targeted radiotherapy that selectively kills tumor cells," says Professor Chou. The first step is to inject the patient with a boron-containing drug, which selectively accumulates in the tumor. Then, NTHU’s nuclear reactor is utilized to perform neutron irradiation to kill the tumor cells (Figure 1).
 
Prof. Chou says that the boron-containing drug BPA has been used in BNCT for patients with head and neck cancer, but it does not specifically accumulate in the liver tumor, and much of it may accumulate in the normal liver tissue and the adjacent pancreas. Therefore, BPA is not suitable for BNCT against liver cancer. However, in the process of searching for a solution, boric acid (BA) was unexpectedly discovered to accumulate selectively in liver tumors (Figure 2).
 
Conducting experiments on rats and New Zealand rabbits, the research team confirmed that BA selectively targets liver tumors and their blood vessels (Figure 2). In animal experiments, the first fraction BA-BNCT treatment reduced the volume of most of the tumors. Twenty days later, a second fraction of BA-BNCT resulted in an overall improvement in the physiological condition and additional shrinkage or even disappearance of the tumor. In fact, 93.75% of the tumors were completely eliminated by two fractions of BA-BNCT. Moreover, histopathological examinations revealed no residual tumor cells in the liver and a lack of damage to normal liver cells. These results confirm that BA-mediated BNCT can deliver a curative radiation dose to tumors and tumor vessels while sparing the normal liver tissue (Figure 3), and multiple liver cancer can be completely eliminated without harming normal liver cells (Figure 4).
 
Figure 1

Figure 1

Figure 2

Figure 2

Figure 3

Figure 3

Figure 4

Figure 4

Prof. Fong-In Chou (right) and assistant

Prof. Fong-In Chou (right) and assistant

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