Potential MCNP Enhancements for NCT

MCNP a Monte Carlo radiation transport code, is currently widely used in the medical community for a variety of purposes including treatment planning, diagnostics, beam design, tomographic studies, and radiation protection. This is particularly true in the Neutron Capture Therapy (NCT) community. The current widespread medical use of MCNP after its general public distribution in about 1980 attests to the code`s general versatility and usefulness, particularly since its development to date has not been influenced by medical applications. This paper discusses enhancements to MCNP that could be implemented at Los Alamos for the benefit of the NCT community. These enhancements generally fall into two categories, namely those that have already been developed to some extent but are not yet publicly available, and those that seem both needed based on our current understanding of NCT goals, and achievable based on our working knowledge of the MCNP code. MCNP is a general, coupled neutron/photon/electron Monte Carlo code developed and maintained by the Radiation Transport Group at Los Alamos. It has been used extensively for radiation shielding studies, reactor analysis, detector design, physics experiment interpretation, oil and gas well logging, radiation protection studies, accelerator design, etc. over the years. MCNP is a three-dimensional geometry, continuous energy physics code capable of modeling complex geometries, specifying material regions such as organs by the intersections of analytical surfaces

An international dosimetry exchange for boron neutron capture therapy, Part I: Absorbed dose measurements

An international collaboration was organized to undertake a dosimetry exchange to enable the future combination of clinical data from different centers conducting neutron capture therapy trials. As a first step Part I the dosimetry group from the Americas, represented by MIT, visited the clinical centers at Studsvik Sweden, VTT Espoo Finland, and the Nuclear Research Institute NRI at Rez Czech Republic. A combined VTT/NRI group reciprocated with a visit to MIT. Each participant performed a series of dosimetry measurements under equivalent irradiation conditions using methods appropriate to their clinical protocols. This entailed in-air measurements and dose versus depth measurements in a large water phantom. Thermal neutron flux as well as fast neutron and photon absorbed dose rates were measured. Satisfactory agreement in determining absorbed dose within the experimental uncertainties was obtained between the different groups although the measurement uncertainties are large, ranging between 3% and 30% depending upon the dose component and the depth of measurement. To improve the precision in the specification of absorbed dose amongst the participants, the individually measured dose components were normalized to the results from a single method. Assuming a boron concentration of 15 microg/g that is typical of concentrations realized clinically with the boron delivery compound boronophenylalanine-fructose, systematic discrepancies in the specification of the total biologically weighted dose of up to 10% were apparent between the different groups. The results from these measurements will be used in future to normalize treatment plan calculations between the different clinical dosimetry protocols as Part II of this study

Current status of boron neutron capture therapy of high grade gliomas and recurrent head and neck cancer

Boron neutron capture therapy (BNCT) is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Clinical interest in BNCT has focused primarily on the treatment of high grade gliomas, recurrent cancers of the head and neck region and either primary or metastatic melanoma. Neutron sources for BNCT currently have been limited to specially modified nuclear reactors, which are or until the recent Japanese natural disaster, were available in Japan, United States, Finland and several other European countries, Argentina and Taiwan. Accelerators producing epithermal neutron beams also could be used for BNCT and these are being developed in several countries. It is anticipated that the first Japanese accelerator will be available for therapeutic use in 2013. The major hurdle for the design and synthesis of boron delivery agents has been the requirement for selective tumor targeting to achieve boron concentrations in the range of 20 μg/g. This would be sufficient to deliver therapeutic doses of radiation with minimal normal tissue toxicity. Two boron drugs have been used clinically, a dihydroxyboryl derivative of phenylalanine, referred to as boronophenylalanine or “BPA”, and sodium borocaptate or “BSH” (Na2B12H11SH). In this report we will provide an overview of other boron delivery agents that currently are under evaluation, neutron sources in use or under development for BNCT, clinical dosimetry, treatment planning, and finally a summary of previous and on-going clinical studies for high grade gliomas and recurrent tumors of the head and neck region. Promising results have been obtained with both groups of patients but these outcomes must be more rigorously evaluated in larger, possibly randomized clinical trials. Finally, we will summarize the critical issues that must be addressed if BNCT is to become a more widely established clinical modality for the treatment of those malignancies for which there currently are no good treatment options.National Institutes of Health (U.S.)United States. Dept. of Energ