第一節 研究結論
癌病治療預估未來半世紀仍是醫學進步突破的挑戰。BNCT 是多項提昇效 益的發展項目之一，榮總與清大多年於BNCT 臨床應用與研究的合作，在國際 此領域已受矚目，佔有一席之地。因癌症放射治療設備與方法，近十年蓬勃且 多元發展，質子治療與重粒子治療在長庚、台大及榮總相繼發展及規劃，世界 各國及台灣於未來十年或二十年間，亦可能因較小型及較不昂貴的質子、碳粒 子治療推出而漸變為像目前普遍使用的直線加速器放射治療，治療效益提昇絕 對是癌病患者之福。但上述各類先進的放療設備與療法皆是體外放療，有其臨 床必要之優點，但亦有其不足之處。為提供癌症治療多元的選擇、進步與突破，
BNCT 標靶放射治療的需求與效益，仍是癌症醫學領域不可或缺及亟待開發之 項目。
有鑑於醫療臨床實用加速器相關放射治療設備的進展，較太空科技及電子 產品之進展顯著較緩慢,目前榮陽團隊仍應在台灣此領域繼續努力。政府核准清 大反應器之許可操作執照，應用尚有近十年的時間，未來應是可繼續延長使用 壽限與運轉。在加速器型BNCT 可於醫院內實用前，榮陽團隊應繼續申請各類 臨床試驗研究，為醫學界開發研究各類癌症治療效益。以目前優異的成果及預 估未來更優異的研究成效宣傳推廣，向政府及企業界申請研究補助及贊助，以 進行更多的臨床研究(有關含硼藥物及臨床試驗病人之醫療花費)。
行來爭取企業界之捐助，包括對癌症有了解及切身體驗的企業界人士，共同為
本人長時間於醫學中心工作，亦為放射腫瘤領域資深人員，在瞭解 BNCT 發展潛力，整合醫院團隊，有幸參與協助清大反應器的研究團隊，共同為國內 唯一之研究用反應器，開啟臨床應用研究，使我國成為目前世界上少數能執行 此臨床治療研究的國家。亦有幸能結合商管知識與自身醫學專業領域，為 BNCT 發展進行開拓整合推動，亦希望此研究能帶動更多人的投入參與，為提 昇台灣癌病醫療水準盡心力。
References
[1 ] Annual Report of Bureau of Health Promotion, Executive Yuan, R.O.C.(Taiwan) 2011:78-97
[2 ] Barth RF, Joensuu H. Boron neutron capture therapy for the treatment of glioblastomas and extracranial tumours: as effective, more effective or less effective than photon irradiation? Radiother Oncol 2007;82:119–22.
[3 ] Bi-monthly report, Japan Association of Nuclear Technology in Medicine, Dec. 2011
[4 ] Burlon AA, Kreiner AJ. A comparison between a TESQ accelerator and a reactor as a neutron sources for BNCT. Nucl Instr Meth Phys Res B 2008;266:763–
71.
[5 ] Blue TE, Yanch JC. Accelerator-based epithermal neutron sources for boron neutron capture therapy of brain tumors. J Neuro oncol 2003;62:19–31.
[6 ] Forton E, .Stichelbaut F, Cambriani A, et al. Overview of the IBA
accelerator-based BNCT system. Applied Radiation and Isotopes 67 (2009) S262–S265
[7 ] Hesteloot K, Lievens Y, Schueren E, 2000. Improved management of radio- therapy departments through accurate cost data, Radiother and Oncol 55, 251–262.
[8 ] IAEA. Current status of neutron capture therapy. In: IAEA TECDOC 1223,Vienna: IAEA; 2001. p. 6–8.
[9 ] Kawabata S, Miyatake S, Kajimoto Y, et al. The early successful treatment of glioblastoma patients with modified boron neutron capture therapy. Report of two cases. J Neurooncol 2003;65:159–65.
[10] Kato I, Ono K, Sakurai Y, et al. Effectiveness of BNCT for recurrent head and neck malignancies. Appl Radiat Isot 2004;61:1069–73.
[11] Kiger JL, Kiger WS, Patel H, et al. Functional and histological assessment of the
ISNCT; 2006. p. 85–8.
[12] Makhankov A, AN ACCELERATOR-BASED THERMAL NEUTRON
SOURCEFOR BNCT APPLICATION, Proceedings of EPAC 2004, Lucerne, Switzerland
[13] Nakagawa Y., Yoshihara H. , Kageji T. et al. Cost analysis of radiotherapy, carbon ion therapy, proton therapy and BNCT in Japan, Appl Radiat Isot 67 (2009) S80–S83
[14] Ono K, Nagata Y, Akuta K, et al. Frequency of micronuclei in hepatocytes following X and fast-neutron irradiations-an analysis by a linear quadratic model. Radiat Res 1990;123:345–7.
[15] Pinelli T, ZontaA, Alteri S, et al. Research and development in neutron capture therapy, in Monduzzi Editorc S.p.A. MEDMOND Inc. 2002
[16] Sakurai Y, Kobayashi T. Controllability of depth dose distribution for neutron capture therapy at the heavy water neutron irradiation facility of Kyoto University Research Reactor. Med Phys 2002;29:2338–50.
[17] Sakurai Y, Kobayashi T. The medical-irradiation characteristics for neutron capture therapy at the heavy water neutron irradiation facility of Kyoto University Research Reactor. Med Phys 2002;29:2328–37.
[18] Suzuki M, Masunaga S, Kinashi Y, et al. Intra-arterial administration of sodium borocaptate (BSH)/lipiodol emulsion delivers B-10 to liver tumors highly selectively for boron neutron capture therapy: experimental studies in the rat liver model. Int J Radiat Oncol Biol Phys 2004;59:260–6.
[19] Suzuki M, Sakurai Y, Masunaga S, et al. Preliminary experimental study of boron neutron capture therapy for malignant tumors spreading in thoracic cavity. Jpn J Clin Oncol 2007;37:245–9.
[20] Suzuki M, Sakurai Y, Masunaga S, et al. Dosimetric studyof boron neutron
[21] Suzuki M, Sakurai Y, Masunaga S, et al. Feasibility of boron neutron capture therapy (BNCT) for malignant pleural mesothelioma from a viewpoint of dose distribution analysis. Int J Radiat Oncol Biol Phys 2006;66:1584–9.
[22] Suzuki M, Sakurai Y, Hagiwara S, et al. First attempt of boron neutron capture therapy (BNCT) for hepato cellular carcinoma. Jpn J Clin Oncol
2007;37:376–81.
[23] Suzuki M, Endo K, Satoh H, et al. A novel concept of treatment of diffuse or multiple pleural tumors by boron neutron capture therapy (BNCT). Radiother Oncol 2008;88:192–5.
[24] Suzuki M, Tanaka H, Sakurai Y, et al. Impact of accelerator-based boron neutron capture therapy (AB-BNCT)on the treatment of multiple liver tumors and
malignant pleural mesothelioma, Radiotherapy and Oncology 2009, doi:10.1016.
[25] Suzuki M, Masunaga S, Kinashi Y, et al. The effects of boron neutron capture therapy on liver tumors and normal hepatocytes in mice. Jpn J Cancer Res 2000;91:1058–64.
[26] Tanaka H, Sakurai Y, Suzuki M, et al. An epithermal neutron generator based on the Be(p,n) reaction using a 30 MeV proton cyclotron accelerator at KURRI.
In:Zonta A, Altieri S, Roveda L, Barth R, editors. 13th International Congress on Neutron Capture Therapy “A new option against cancer”. Roma: ENEA;
2008.p. 510–3.
[27] 波特五力分析
維基百科網站 http://zh.wikipedia.org/zh-tw/五力分析 [28] SWOT 分析
維基百科網站 http://zh.wikipedia.org/zh-tw/SWOT