Background/Aim: Most patients with hepatocellular carcinoma (HCC) cannot be treated using traditional therapies. Boron neutron capture therapy (BNCT) may provide a new treatment for HCC. In this study, the therapeutic efficacy and radiobiological effects of boric acid (BA)-mediated BNCT in a VX2 multifocal liver tumor-bearing rabbit model are investigated. Materials and Methods: Rabbits were irradiated with neutrons at the Tsing Hua Open Pool Reactor 35 min following an intravenous injection of BA (50 mg 10 B/kg BW). The tumor size following BNCT treatment was determined by ultrasonography. The radiobiological effects were identified by histopathological examination. Results: A total of 92.85% of the tumors became undetectable in the rabbits after two fractions of BNCT treatment. The tumor cells were selectively eliminated and the tumor vasculature was collapsed and destroyed after two fractions of BA-mediated BNCT, and no injury to the hepatocytes or blood vessels was observed in the adjacent normal liver regions. Conclusion: Liver tumors can be cured by BA-mediated BNCT in the rabbit model of a VX2 multifocal liver tumor. BA-mediated BNCT may be a breakthrough therapy for hepatocellular carcinoma.Liver cancer is one of the most common types of cancer; it is the second most common cause of death from cancer worldwide (1). The prognosis for liver cancer is poor (2). Surgery is the best treatment for patients with a focal liver tumor. However, most hepatoma patients are diagnosed at an advanced stage. Liver cancer cannot be completely cured by surgery due to the large tumor size and vascular invasion, and more than 80% of patients suffer from complications with multifocal tumors (3). The multiport irradiation that is often used in HCC treatment delivers a radiation dose that could exceed the tolerable level of the normal liver, which may cause fatal liver failure (4, 5). Current chemotherapy, surgical treatment and traditional radiation therapies have limited efficacy in eradicating the hepatoma (6, 7). New therapeutic methods with improved efficacy and fewer complications need to be developed.Boron neutron capture therapy (BNCT) is an internal target therapy, which enables a restricting zone of the boron neutron capture reaction to be selected. It is a two-step therapeutic modality, which is based on the selective uptake of 10 B compounds by tumor cells, followed by neutron irradiation. When such aspects are kept separately, BNCT has minor effects on normal tissues. In contrast to other anticancer drugs, a 10 B compound that is used in BNCT does not have any therapeutic effect by itself; the agent is only used to transport 5495
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