Neutron capture therapy is a binary system that consists of two separate components to achieve its therapeutic effect. Each component in itself is non-tumoricidal, but when combined together they are highly lethal to cancer cells.BNCT is based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which makes up approximately 20% of natural elemental boron, is irradiated with neutrons of the appropriate energy to yield excited boron-11 (11B*). This undergoes instantaneous nuclear fission to produce high-energy alpha particles (4He nuclei) and high-energy lithium-7 (7Li) nuclei. BNCT bestows upon the nuclear reaction that occurs when Boron-10, a stable isotope, is irradiated with low-energy thermal neutrons to yield α particles (Helium-4) and recoiling lithium-7 nuclei. • The unique property of BNCT is that it can deposit a large dose gradient between the tumour cells and normal cells. The selective delivery of sufficient amounts of 10B to the tumor with only small amounts localized in the surrounding normal tissues.Thus, normal tissues, if they have not taken up sufficient amounts of boron-10, can be spared from the nuclear capture and fission reactions. Normal tissue tolerance is determined by the nuclear capture reactions that occur with normal tissue hydrogen and nitrogen. BNCT, therefore, can be regarded as both a biologically and a physically targeted type of radiation therapy.

1. Boron neutron Capture therapy
PRESENTED BY:-
SAYLI S. DALVI.
F.Y.M.PHARM.(PHARMACEUTICS)
UNDER GUIDANCE OF:-
DR.(MRS.)GANGA SRINIVASAN.
(H.O.D PHARMACEUICS)
VES COLLEGE OF PHARMACY,CHEMBUR.

2. Table of Contents.
 Introduction
 Challenges in conventional therapy
 Technology of BNCT
 Advantages over conventional methods
 Drugs and Accelerators for BNCT
 Clinicalapplications
 Case studies
 Conclusion
 References
 Acknowledgement
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3. Introduction To BNCT
 There is an increase in cancer burden day by day. The mainstream treatment modalitiesin treating cancer are
surgery, chemotherapy and radiotherapy.
 Surgical annihilation is highly efficient in primary tumours, but it is limited to surgicallysizeableand approachable
tumours and thus cancer cellsmay not be wholely evacuated.
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4. Introduction To BNCT
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5. Introduction To BNCT
 What is BNCT ?
 GordonLocherwas the first one to proposethe principleof BNCT in 1936andhypothesizedthatif boroncouldbe selectivelyconcentratedin a tumour
mass andthe volumethen exposedto thermalneutrons,a higherradiationdose to thetumourrelativeto adjacent normal tissue would be produced
 A typeof radiationtherapy.A substancethat containsboronis injected into a bloodvessel. Theboroncollectsin tumor cells. The patientthen receives
radiationtherapywith atomic particlescalledneutrons.The neutronsreactwith the boronto killthe tumor cellswithout harmingnormal cells.
 BNCT is consideredas a rationaleand promisingbinarytherapymodality fortreatmentof severalcancersin particularmalignant gliomas.
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6. Challenges in conventional therapy
 The conventional treatment involves surgery, after which chemotherapy and radiation therapy.
 Radiation utilizes high energy ionization particles like X-rays, gamma rays or electrons, to damage cells at molecular level and
is often used as an integral approach, to exterminate remaining cancer cells after surgery.
 It commonly has significant side effects due to drug toxicity to normal cells and is subject to the development of resistance by
the cancer cells.
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7. Challenges in conventional therapy
 It can cause destruction to the lively/healthy tissues neighbouring the cancer cells or in the lane of radiation beam.
 Chemotherapy is the use of chemical drugs in the form of pills, capsules, IV to fight cancer. The systemically
administrated drugs circulate in the body to kill cells that divide rapidly, especially cancer cells.
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8. Challenges in conventional therapy
 Treatment of glioblastoma with these conventional therapies is very
difficult due to several complicating factors:-
 The tumor cells are very resistant to conventional therapies.
 The brain is susceptible to damage from conventional therapy.
 The brain has a very limited capacity to repair itself.
 Many drugs cannot cross the blood–brain barrier to act on the tumor.
 Gliomas can occur in the brain and in various locations in the nervous
systems, including the brain stem and spinal column.
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9. BNCT Technology
 BNCT is based on the nuclear capture and fission reactions that occur when boron-10, a non-radioactive
constituent of natural elemental low-eboron, is irradiated with nergy (0.025 eV) thermal neutrons or
alternatively,higher-energy (10,000 eV) epithermal neutrons, which lose energy as they penetrate tissues
and become thermalized.
 This capture reaction results in the production of high linear energy transfer alpha particles (4He) and
recoiling lithium-7 (7Li) nuclei.
 The unique property of BNCT is that it can deposit a large dose gradient between the tumour cellsand
normal cells.
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Principles of BNCT

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Principles of BNCT
Alpha particles (4He) and the recoiling of lithium-7(7Li) nuclei.

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Principles of BNCT
The destructive effects of these high energy particles are limited to boron containing cells.

13. Technology of BNCT:-
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14. Technology of BNCT:-
 BNCT bestows upon the nuclear reaction that occurs when Boron-10, a stable
isotope, is irradiated with low-energy thermal neutrons to yield α particles
(Helium-4) and recoiling lithium-7 nuclei.
 A large number of 10 Boron (10B) atoms have to be localized on or within
neoplastic cells for BNCT to be effective, and an adequate number of thermal
neutrons have to be absorbed by the 10B atoms to maintain a lethal 10B (n, α)
lithium-7 reaction.
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10B + n 7Li + 4He

15. BNCT Technology
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16. Obstacle for BNCT
 So why is BNCT not yet a mainstream cancer treatment?
 The main obstacle is that, historically, BNCT required a nuclear reactor to generate the neutron
beams needed for treatments.
 Insufficient tissue penetrating properties of the thermal neutron beams
 To overcome this problem, California-based TAE Life Sciences is developing an accelerator-
based neutron source.
 They have created a low-energy neutron beam source that is reliable, compact and can be
installed in a hospital facility.
 “This changes the game on BNCT.”
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Accelerator used for BNCT

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Block diagram representing the procedure for BNCT

19. Boroneted Compounds
1st Generation
Boron
Compounds
• Eg.-
• Boric Acid and
Derivatives
2nd Generation
Boron
Compounds
• Eg.-
• BPA
• BSH
3rd Generation
Boron Compounds
• Biomolecules
• Eg.-liposomes,
Monoclonal antiboldies
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20. Ideal Properties of Boron
compounds
 Low systemic toxicity
 Normal tissue uptake is lesserwith respect to tumour uptake,
 High tumour /brain and tumour /blood concentration ratios (>3-4:1),
 Tumour concentrations of 20-35mg10B/g tumour
 Rapid clearance from blood and normal tissues and persistence in tumour during BNCT.
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21. Advantages over conventional
therapies
• Aggressive and
combined local
treatment including
surgery and
chemo-radiation
has been applied to
advanced head and
neck cancer, but
the prognosis for
patients with
recurrent disease is
generally poor.
Conventional
Therapies
• BNCT is emerging as
a hopeful tool in
treating cancer, by
selectively
concentrating Boron
compounds in
tumour cells and then
subjecting the
tumour cells to
epithermal neutron
beam radiation which
selectively destroys
the tumour cells.
BNCT
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22. Advantages over conventional
therapies
The unique property of BNCT is that it can deposit a
large dose gradient between the tumour cells and
normal cells.
BNCT is ideally placed to treat complex targets, such
as tumours that infiltrate normal tissue or are near
critical structures, as well as radio resistant and
recurrent tumours
For large head-and-neck tumours, BNCT provides
better cosmetic outcomes and less scarring than
surgery or standard radiotherapy.
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23. Clinical Applications
Clinical studies on BNCT of high grade
gliomas and head and neck cancers
Treatment of recurrent tumors of the head and
neck region with BNCT
Treatment of cutaneous melanomas with
BNCT
Treatment of genital cancers with BNCT
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24. Clinical Applications
Kankaanranta L et al. - 22
patients with recurrent GBM,
who had recurrence on
standard treatment were
subjected to BNCT using BPA.
It was concluded that BNCT
can be used as a rescue
therapy in patients with
recurrent tumours.
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25. Clinical Applications
A total of 26 patients
(19 squamous cell
carcinomas, 4
salivary gland
carcinomas and 3
sarcomas)
They were treated
with BNCT due to
recurrence after
standard therapy.
Their response rate
was 85%, with mean
survival time of 33.6
months.
It was concluded that
BNCT had improved
the survival period
and quality of life in
patients with
recurrent HNM
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26. Clinical Applications
Nineteen patients with recurrent malignant meningioma were subjected to BNCT.
Within the observation period there was more than 50% reduction in the tumour mass in 18
out of 19 cases.
Presently six patients are still alive. The median survival time post BNCT was reported to be
14.1 months.
It is clearly noticeable that BNCT provides a better ground to treat recurrent malignant
meningioma cases successfully
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27. Clinical Applications
 Ten patients were enrolled for a phase I/II clinical trial of BNCT
in Taiwan, for recurrent-late staged head and neck cancer.
 BNCT was performed with BPA-fructose intravenously in two
phases.
 Their recent findings demonstrated that after a median follow-
up of 11.3 months.
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28. Clinical Applications..Cntd.
Three patients had shown complete
response
three had shown partial response
two showed stable diseases
two patients had shown progression of
their disease status.
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29. Case Studies
 A 67-year-old woman was diagnosed with mucoepidermoid carcinoma of parotid gland and
underwent a parotidectomy, followed by radio-therapy.
 Tumor recurred and additional chemotherapy was ineffective.
 The ulcerated tumor had grown to 13.512.58cm3 and caused pain, bleeding and mucous
exudates
 The tumor had shrunk by 63%, one-month after the first BNCT. BNCT caused great
effects on the patient such as tumor reduction, relief of pain and exudates-secretion from
the ulceration, in spite of slight side effects such as transient mucositis, and alopecia
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30. Case Studies
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31. Case Studies
 Representative tumor shrinkage after BNCT
demonstrated
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32. Case Studies
 Representative tumor shrinkage after BNCT demonstrated on axial (A, B, E, F, I, J, M
and N)
 and sagittal (C, D, G, H, K, L, O, and P) Gd-enhanced MR images.
 Each case shows marked tumor volume reduction after BNCT.
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33. Conclusion
 The concept of BNCT though had evolved in 1936, there has been a steady
improvement in knowing and understanding the science behind it, working out with
the clinical trials and putting it to clinical use.
 Though may be for now BNCT may not have gained its popularity, but definitely in
near future BNCT will be a milestone in the field of radiotherapy for treating
cancers.
 In conclusion, BNCT still remains an attractive twenty first century treatment option
for hard to treat types of human cancers.
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34. References
1. Ganjeh ZA, Eslami-Kalantari M. Design and optimization of two-sided
beam based on 7Li (p, n) 7Be source using in BNCT for brain and liver
tumors. Nuclear Instruments and Methods in Physics Research Section A:
Accelerators, Spectrometers, Detectors and Associated Equipment. 2019
Feb 1;916:290-5.
2. Barth RF, Zhang Z, Liu T. A realistic appraisal of boron neutron capture
therapy as a cancer treatment modality. Cancer Communications. 2018
Dec;38(1):36.
3. Barth RF, Soloway AH, Brugger RM. Boron neutron capture therapy of
brain tumors: past history, current status, and future potential. Cancer
investigation. 1996 Jan 1;14(6):534-50.
4. https://physicsworld.com/a/boron-neutron-capture-therapy-
progresses-towards-clinical-cancer-treatments/
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35. References
1. Barth RF, Mi P, Yang W. Boron delivery agents for neutron capture
therapy of cancer. Cancer Communications. 2018 Dec 1;38(1):35.
2. Dorn RV. Boron neutron capture therapy (BNCT): a radiation
oncology perspective. International Journal of Radiation Oncology*
Biology* Physics. 1994 Mar 30;28(5):1189-201.
3. Gahbauer R, Gupta N, Blue T, Goodman J, Barth R, Grecula J, Soloway
AH, Sauerwein W, Wambersie A. Boron neutron capture therapy:
principles and potential. InFast Neutrons and High-LET Particles in
Cancer Therapy 1998 (pp. 183-209). Springer, Berlin, Heidelberg.
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36. I would pleased to thank our Principal Madam Dr.(Mrs.) Supriya Shidhaye for
her constant support and motivation. I like to thank my Guide Dr.(Mrs.)Ganga
Srinivasan mam for giving me an opportunity to explore the newly upgrading cancer
treatment; BNCT.
I would also like to thankour evaluators and the audience for their time and
patience.
And At last but not the least, thank to my family and my friends for always
helping and motivating me.
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