Boron dose enhancement for Cf-252 brachytherapy

Full text: Monte Carlo modelling of a Cf-252 source in water and in tissue has shown that there is a significant therapeutic advantage obtained if B-10 is present in the tumour cells. This study analyses the advantage in terms of therapeutic margin, defined as the distance from the border of the treatment volume where boron-loaded tumour cells will receive a therapeutic dose. Calculations were made with MCNP version 4a on a Pentium 60 MHz computer. Large voxel sizes allowed 70 minute runs to achieve statistical uncertainties of 5% or less for 100,000 source neutrons. Later runs with smaller voxels confirmed the accuracy of the initial calculations. Calculations were made for treatment volume radii up to 11 cm and 30 ppm boron-10. The therapeutic margin for radii in the range 3-9 cm is approximately 10% of the tumour radius. This results in a 30% increase in the volume inside which peripheral tumour cells may receive a therapeutic dose. The median therapeutic ratio within the therapeutic margin varied from 1.05 at 3 cm up to 1.25 at 10 cm. Thus there is little benefit for less advanced tumours with thickness less than 3 cm. However, cervical cancer frequently presents in an advanced state in Southeast Asia and in Aboriginal communities in Australia, partially attributable to low Pap smear screening rates. These conclusions support the development and testing of boron compounds in in vitro and in vivo models for cervical cancer