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As pigment cells undergo melanoma genesis, accentuated melanogenesis concurrently occurs in principle. Subsequent to the understanding of intrinsic factors controlling both processes, we found our selective melanoma neutron capture therapy (NCT) using 10B-dopa (melanin substrate) analogue, 10B1-p-boronophenylalanine (10B1-BPA), followed by 10B(n, alpha)7Li reaction, induced by essentially harmless thermal neutrons, which releases energy of 2.33 MeV to 14 mu, the diameter of melanoma cells. In vitro/in vivo radiobiological analysis revealed the highly enhanced melanoma killing effect of 10B1-BPA. Chemical and prompt gamma ray spectrometry assays of 10B accumulated within melanoma cells after 10B1-BPA administration in vitro and in vivo show high affinity, e.g., 10B melanoma/blood ratio of 11.5. After successfully eradicating melanoma transplanted into hamsters with NCT, we advanced to preclinical studies using spontaneously occurring melanoma in Duroc pig skin. We cured three melanoma cases, 4.6 to 12 cm in diameter, by single neutron capture treatment. Complete disappearance of melanoma was obtained without substantial side effects. Acute and subacute toxicity as well as pharmacodynamics of 10B1-BPA have been studied in relation to therapeutic dosage requirements. Clinical radiation dosimetry using human phantom has been carried out. Further preclinical studies using human melanoma transplanted into nude mouse have been a useful model for obtaining optimal results for each melanoma type. We recently treated the first human melanoma patient with our NCT, using essentially the method for Duroc pig melanoma, and obtained similar regression time course leading to cure.

A patient with malignant melanoma was treated by thermal neutron capture therapy using 10B-paraboronophenylalanine. The compound was injected subcutaneously into ten locations in the tumor-surrounding skin, and the patient was then irradiated with thermal neutrons from the Musashi Reactor at reactor power of 100 KW and neutron flux of 1.2 X 10(9) n/cm2/s. Total absorbed dose to the skin was 11.7-12.5 Gy in the radiation field. The dose equivalents of these doses were estimated as 21.5 and 24.4 Sv, respectively. Early skin reaction after irradiation was checked from day 1 to day 60. The maximum and mean skin scores were 2.0 and 1.5, respectively, and the therapy was safely completed as far as skin reaction was concerned. Some factors influencing the absorbed dose and dose equivalent to the skin are discussed.

Human melanoma regression by single thermal neutron capture therapy (NCT) using melanoma-seeking 10B compounds has been achieved. Since 1972, the aim of my team has been to synthesize tumor-seeking 10B-compounds possessing selective affinity for specific metabolic activity of the target cancer cells. Once the melanoma takes up these 10B compounds, thermal neutrons, which cause insignificant cell damage, are easily absorbed by nonradioactive 10B, inducing the 10B(n, alpha)7Li reaction and releasing the high LET particles to 14 mu melanoma cell diameter, destroying the tumor without damaging surrounding tissue. Radiobiological and preclinical studies culminated in the first successful human NCT treatment, with no recurrence of the treated melanoma since July, 1987.