Abstract:
:Boron neutron capture therapy (BNCT) is based on the nuclear reaction that occurs when boron-10, a stable isotope, is irradiated with low-energy thermal neutrons to yield alpha particles and recoiling lithium-7 nuclei. For BNCT to be successful, a large number of 10B atoms must be localized on or preferably within neoplastic cells, and a sufficient number of thermal neutrons must be absorbed by the 10B atoms to sustain a lethal 10B (n, alpha) lithium-7 reaction. There is a growing interest in using BNCT in combination with surgery to treat patients with high-grade gliomas and possibly metastatic brain tumors. The present review covers the biological and radiobiological considerations on which BNCT is based, boron-containing low- and high-molecular weight delivery agents, neutron sources, clinical studies, and future areas of research. Two boron compounds currently are being used clinically, sodium borocaptate and boronophenylalanine, and a number of new delivery agents are under investigation, including boronated porphyrins, nucleosides, amino acids, polyamines, monoclonal and bispecific antibodies, liposomes, and epidermal growth factor. These are discussed, as is optimization of their delivery. Nuclear reactors currently are the only source of neutrons for BNCT, and the fission reaction within the core produces a mixture of lower energy thermal and epithermal neutrons, fast or high-energy neutrons, and gamma-rays. Although thermal neutron beams have been used clinically in Japan to treat patients with brain tumors and cutaneous melanomas, epithermal neutron beams now are being used in the United States and Europe because of their superior tissue-penetrating properties. Currently, there are clinical trials in progress in the United States, Europe, and Japan using a combination of debulking surgery and then BNCT to treat patients with glioblastomas. The American and European studies are Phase I trials using boronophenylalanine and sodium borocaptate, respectively, as capture agents, and the Japanese trial is a Phase II study. Boron compound and neutron dose escalation studies are planned, and these could lead to Phase II and possibly to randomized Phase III clinical trials that should provide data regarding therapeutic efficacy.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Barth RF,Soloway AH,Goodman JH,Gahbauer RA,Gupta N,Blue TE,Yang W,Tjarks Wdoi
10.1097/00006123-199903000-00001keywords:
subject
Has Abstractpub_date
1999-03-01 00:00:00pages
433-50; discussion 450-1issue
3eissn
0148-396Xissn
1524-4040journal_volume
44pub_type
杂志文章,评审相关文献
NEUROSURGERY文献大全abstract:BACKGROUND AND IMPORTANCE:The natural history of pineal region germ cell tumors (GCTs) is not well known. We report a rare case of a pineal region GCT showing rapid enlargement within 2 months, after 7 years with no growth. CLINICAL PRESENTATION:A boy presented with gonadotropin-independent precocious puberty at 6 yea...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e318284708a
更新日期:2013-04-01 00:00:00
abstract::Four cases of intracerebral hemorrhage remote from the site of the initial neurosurgical procedure are presented. Two of the four patients had preoperative hypertension. Possible mechanisms are discussed, and labile hypertension and unstable blood pressure during the perisurgical period may be contributory. Clinical a...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198312000-00008
更新日期:1983-12-01 00:00:00
abstract:OBJECTIVE:Despite apparent gross total resection, olfactory groove meningiomas have a high rate of late recurrence (average, 23%). In this retrospective study, we confirmed that the sites of these recurrences are the cranial base and paranasal sinuses. We postulated that these recurrences stem from conservative handlin...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000079484.19821.4a
更新日期:2003-09-01 00:00:00
abstract::An unusual case of a chronic posttraumatic lumbar intradural arachnoid cyst causing compression of the cauda equina is reported. The etiological, pathological, and clinical features are discussed. Emphasis is placed on the importance of a correct interpretation of radiological findings. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198704000-00024
更新日期:1987-04-01 00:00:00
abstract::Five intramedullary cavernous angiomas were surgically removed after being localized by intraoperative ultrasound imaging. Two patients were men, and three were women; in three patients, the symptoms had an acute onset, whereas in the other two, it was gradual. The vascular malformation was localized in the dorsal tra...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199403000-00020
更新日期:1994-03-01 00:00:00
abstract:INTRODUCTION:Interest in using the extended endonasal transsphenoidal approach for management of suprasellar lesions, with either a microscopic or endoscopic technique, has increased in recent years. The most relevant benefit is that this median approach permits the exposure and removal of suprasellar lesions without t...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.neu.0000289708.49684.47
更新日期:2007-09-01 00:00:00
abstract::The clinical and radiographic presentations of 3 patients with intraventricular cavernous hemangioma are described. The accumulated total of 19 cases from the literature are compared to determine whether there is a common clinical and radiographic presentation for this benign intraventricular lesion. The differential ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198502000-00011
更新日期:1985-02-01 00:00:00
abstract:OBJECTIVE:Radical resection of facial nerve schwannomas classically implies a high risk of severe facial palsy. Owing to the rarity of facial palsy after gamma knife surgery (GKS) of vestibular schwannomas, functional evaluation after GKS seems rational in this specific group of patients. To our knowledge, no previous ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000249282.46514.DA
更新日期:2007-05-01 00:00:00
abstract::Axial magnetic resonance (MR) images of non-neoplastic spinal cord cavities were reviewed in 115 patients with otherwise complete neurological and neuroradiological findings. The variations in axial morphology revealed three distinct cavitary patterns. These patterns were as follows: 1) symmetrically enlarged central ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199508000-00003
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND AND IMPORTANCE:Spinal extradural arteriovenous fistula (SEDAVF) with parenchymal drainage (type A) is a rare clinical entity that causes venous congestive myelopathy. Treatment includes endovascular and open microsurgical interventions. We reviewed the clinical records of patients treated for a type A SEDAVF...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000189
更新日期:2013-12-01 00:00:00
abstract::An aneurysm of a persistent primitive hypoglossal artery (PHA) particularly at its junction with the basilar artery, often poses therapeutic problems. This is attributable not only to the size and location of the aneurysm but also to the fact that the persistent PHA is functionally the single artery providing blood in...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:
更新日期:1992-05-01 00:00:00
abstract::We describe newly developed tumor-holding clips, which have been applied in more than 50 patients with large or deep-seated tumors. We devised various kinds of standard tumor clips by modifying Sugita aneurysm clips. Our new tumor clips permit gentle, steady, and easy retraction of the tumor in any direction without d...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199507000-00027
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Observational methods can be used in conjunction with the comparative effectiveness research (CER) paradigm to inform decisions between alternative patient management strategies in real-world clinical settings. OBJECTIVE:To present a brief review of current observational research regarding 3 strategies for ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e31820cd45a
更新日期:2011-06-01 00:00:00
abstract::Although surgeons in Austria, especially in Vienna, were counted among the leading specialists at the end of the 19th century, neurosurgery did not evolve as a distinct discipline before the turn of the century; achievements were episodic until Anton von Eiselsberg became an enthusiastic surgeon of the central nervous...
journal_title:Neurosurgery
pub_type: 历史文章,杂志文章
doi:10.1097/00006123-200204000-00033
更新日期:2002-04-01 00:00:00
abstract::Seventy-five patients older than 60 years of age underwent surgical resection of intracranial meningiomas during a 10-year period at a single institution. All patients had a computed tomographic scan preoperatively, and all were followed for at least 3 months postoperatively. There were 50 patients 61 to 70 years of a...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198904000-00011
更新日期:1989-04-01 00:00:00
abstract::This pilot study presents a possible modification of direct cortical electrical stimulation technique for the recording of motor evoked potentials under general anesthesia. The exposed primary motor cortex was stimulated by a short train of anodal rectangular pulses at high frequency (300-500 Hz), while the compound m...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199302000-00011
更新日期:1993-02-01 00:00:00
abstract::Dorsal root entry zone lesions are effective in the control of intractable pain in several types of spinal cord injuries. Traditionally, these lesions have been made with the radiofrequency technique. This is effective, but has the drawback of being laborious, and there is a significant incidence of permanent weakness...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198503000-00008
更新日期:1985-03-01 00:00:00
abstract::The author looks back on his more than 70 years of familiarity with Americans involved in warfare, noting their loyal support for our country's objectives. Drawing on the Einstein equation, his own visits to Hiroshima and Nagasaki, and current literature, he, as a physician, belatedly concurs with those who look on th...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198304000-00001
更新日期:1983-04-01 00:00:00
abstract:OBJECTIVE:Hemifacial spasm caused by a cerebellopontine angle lipoma is extremely rare. We describe a patient with left-sided hemifacial spasm caused by vascular compression of the facial and vestibulocochlear cranial nerves by the anteroinferior cerebellar artery embedded within a cerebellopontine angle lipoma. CLINI...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000325734.30302.97
更新日期:2008-10-01 00:00:00
abstract::The residency program in neurological surgery at Northwestern University was founded in 1924 by Loyal Davis and was formally accredited by the American Board of Neurological Surgery in 1946. Allen Kanavel, mentor to Davis, was one of the original members of the Society of Neurological Surgeons. Five individuals have s...
journal_title:Neurosurgery
pub_type: 历史文章,杂志文章
doi:10.1097/00006123-199810000-00111
更新日期:1998-10-01 00:00:00
abstract::This report describes the successful removal of a ruptured dominant hemisphere arteriovenous malformation that arose in the region of the basal ganglia and was supplied by the lenticulostriate arteries. Obliteration of the lesion was accomplished by a transcerebral approach from above, utilizing the preexisting hemato...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract:OBJECTIVE:The anterior lumbar interbody fusion (ALIF) procedure has become an accepted fusion technique for treating patients with degenerative disorders of the lumbar spine. Many consider laparoscopic ALIF to be the least invasive approach. A modification of the open laparotomy--the "mini-open" approach--is an attract...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200207000-00015
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE:Reports from relatively small series of pediatric patients predominantly from single centers have hampered accurate analysis of outcome from endoscopic third ventriculostomy. We combined patients from nine pediatric neurosurgery centers across Canada to obtain a better estimate of outcome and identify factors...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1227/01.NEU.0000255420.78431.E7
更新日期:2007-05-01 00:00:00
abstract::Previous studies have suggested that certain prostanoids are mediators of the pathological features of subarachnoid hemorrhage (SAH) and that a reduced synthesis of prostacyclin in the vessel wall might also contribute to the cerebral vasospasm associated with this malady. The present study was performed, therefore, t...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198301000-00008
更新日期:1983-01-01 00:00:00
abstract:OBJECTIVE:Intracranial dural arteriovenous fistulae (DAVFs) can present as disabling intracranial hemorrhage. The aim of this study was to investigate the independent effects of specific demographic and clinical variables on hemorrhagic presentation in patients with DAVFs. METHODS:All patients with DAVFs evaluated at ...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1227/01.neu.0000317311.69697.fc
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:Delayed cerebral ischemia resulting from vasospasm is a major cause of morbidity and death in patients with aneurysmal subarachnoid hemorrhage. Milrinone, because it inhibits Type IV cyclic adenosine monophosphate-specific phosphodiesterase enzyme in both cardiac and vascular smooth muscle, is a powerful inot...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199702000-00025
更新日期:1997-02-01 00:00:00
abstract::Anterior cervical instrumentation as an adjunct to bone fusion has an important role in cervical spine surgery. Posterior vertebral body cortex purchase is strongly recommended in the use of the Caspar system, although few biomechanical data exist to validate this requirement. In this study, Caspar screws were placed ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199212000-00016
更新日期:1992-12-01 00:00:00
abstract::Fourteen patients with acoustic neurinomas varying in size from 7 to 30 mm were treated by stereotactic radiosurgery and then were followed for 4 years. The tumors of eight patients decreased 1 to 10 mm in diameter, no change was found in two, and the tumor increased slightly in three patients. Loss of the ability to ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198307000-00003
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVE:To review our experience of managing idiopathic normal pressure hydrocephalus (iNPH) during the 6-year period from 2002 to 2007, when intracranial pressure (ICP) monitoring was part of the diagnostic workup. METHODS:The review includes all iNPH patients undergoing diagnostic ICP monitoring during the years 2...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.NEU.0000363408.69856.B8
更新日期:2010-01-01 00:00:00
abstract::We performed a retrospective study of 107 consecutive patients with syndromic forms of craniosynostosis (craniofacial dysostosis) seen by the craniofacial team at the Hospital for Sick Children between 1986 and 1992. There were 51 patients with Crouzon's syndrome, 33 with Apert's syndrome, 8 with Pfeiffer syndrome, 11...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199504000-00010
更新日期:1995-04-01 00:00:00