Computational assessment of improved cell-kill by gadolinium-supplemented boron neutron capture therapy.

Potential improvement in neutron capture therapy (NCT) by utilizing both 157Gd and 10B is assessed considering two parameters calculated in transport models in MCNP4B, the dose to quiescent cells and the therapeutic ratio. Improved sterilization of quiescent or more generally non-uptaking cells is demonstrated with the addition of 157Gd to conventional 10B loading. The improved dose delivery to non-uptaking cells from concurrent administration of 157Gd and 10B is weighed against a second index, degradation in the therapeutic ratio resulting from the longer interaction lengths of the 157Gd capture products. Optimal concentrations of 157Gd are determined considering varying assumptions for boron uptake levels and selectivity. By analysing the dosimetry results of varying 157Gd concentrations applied concurrently with BPA-delivered boron in NCT, this work seeks to determine a balance between the high tumour-specific dose provided by BPA and the high dose to quiescent cells provided by potential gadolinium agents. Depending upon the assumptions for drug specificity, tumour size and fraction of quiescent cells, NCT with low levels of 157Gd (125 microg g(-1)) supplementing 10B loadings was shown to be superior to treatments applying 10B alone.