Novel Pharmacological and Magnetic Resonance Strategies to Enhance Boron Neutron Capture therapy (BNCT) Efficacy in the clinical treatment of Malignant Glioma

Management of CNS Tumors is a selected review of Central Nervous System (CNS) tumors with particular emphasis on pathological classification and complex treatment algorithms for each common tumor type. Additional detailed information is provided on selected CNS tumor associated disorders. Chapter 11 is focused on developing solutions to overcome Boron Neutron Capture Therapy ( BNCT) limitations, in order to make it a clinically useful treatment modality in the near future. Specifically, we have evaluated in vivo (using C6 glioma model) the pharmacokinetics of BPA, and the effect of L-DOPA preloading on BPA accumulation both in the tumour and normal tissues. Pharmacokinetic data were helpful in determining the optimal irradiation time, as well as to develop computational strategies in order to define as accurately as possible the radiation dose released within tumour and surrounding healthy tissues. These results demonstrate that both 19F MRI and 19F MRS are feasible and practical methodologies with potential future clinical application. Indeed, 19F NMR can be performed with an 1H MR clinical scanner with only minor hardware and software improvements. Both of the solutions proposed to improve BNCT effectiveness will help the therapy to overcome its main hindrances to become a clinically useful modality in the near future.