Tıpta Bor Rönesansı: Kapsamlı bir Biyofizik ve Tıbbi Fizik Derlemesi

Abstract

Borun yeni tıbbi teknolojilerdeki kullanımı, eski ve yeni teknolojiler arasındaki etkileşimin bir sonucu olarak keskin bir canlanma geçirmektedir. Küçük, hastane tabanlı hızlandırıcı nötron kaynaklarının ortaya çıkmasıyla birlikte, Bor Nötron Yakalama Tedavisi (BNCT) artık geçmişteki nükleer reaktörlerle sınırlı kalmamakta, böylece daha çeşitli klinik ortamlarda kullanım fırsatı bulmaktadır. Modern biyomedikal çalışmalarda nanoteknoloji, borun yeni biyofiziksel kullanım alanlarına kapı aralamaktadır; bunlar arasında hedeflenmiş farmakolojik iletim, teranostik ajanlar ve radyoduyarlaştırıcılar (radyosensitizörler) yer almaktadır. Bu derleme, bor tabanlı terapötiklerin temel biyofiziksel biyobelirteçlerinin, klinik kanıtların ve gelecekteki teknolojik gelişmelerin bir sentezidir. Bor nötron yakalama tedavisi (BNCT), Japonya'da nükseden baş ve boyun malignitelerinin tedavisi için klinik onay almıştır; ancak bor iletim ajanlarının optimal seçiciliğinin eksikliği ve in-vivo gerçek zamanlı dozimetri yetersizliği nedeniyle genel translasyonel yararlılığı sınırlıdır. Bu tür sınırlama alanları, özellikle üçüncü nesil nanotaşıyıcılar ve gelişmiş görüntüleme modaliteleri kullanılarak gerçekleştirilecek inovasyonlar için verimli zeminler oluşturmaktadır. Daha da önemlisi, bor terapötiklerinin bilimsel canlanması, kendine özgü jeopolitik bağlamında tartışılmaktadır. Bor rezervleri açısından dünyada hâkim bir figür olarak bilinen Türkiye, sadece bir hammadde tedarikçisi olmaktan uzaklaşıp yüksek katma değerli bor tabanlı tıbbın küresel öncüleri arasında yer almak adına tarihi boyutlarda bir fırsat sunan stratejik bir kaynaktır. Buna ek olarak derleme, (2004-2026 yılları arasında Türk kurumlarında yayınlanan) 26 özgün araştırma kaynağının bibliyometrik değerlendirmesini içermekte olup, bu değerlendirme polimer kimyası tabanlı bir temelden, karmaşık teranostiklere ve reaktör fiziğine doğru daha ileri bir kaymayı tasvir etmektedir. Son olarak derlemede, translasyonel ilerlemeye yönelik uygulanabilir (aksiyon alınabilir) yönlendirmelerle birlikte, bu kaynak hegemonyasının kullanımına dair stratejik perspektifler ele alınmaktadır.

Keywords

• Bor Nötron Yakalama Terapisi
• Tıbbi Fizik
• Biyofizik
• Bor Taşıyıcı Ajanlar
• Hızlandırıcı Nötron Kaynakları
• Nanotıp

The Boron Renaissance in Medicine: A Comprehensive Biophysical and Medical Physics Review

Abstract

The usage of boron in new medical technology is undergoing a sharp advancement, brought about as a result of the interaction between old and new technologies. With the appearance of small hospital-based accelerator neutron sources, Boron Neutron Capture Therapy (BNCT) is no longer limited to the nuclear reactors in the past, thus providing it with an opportunity to be used in a wider variety of clinical settings. Nanotechnology in modern-day biomedical studies is opening the doors to fresh biophysical uses of boron and these include targeted pharmacological delivery, theranostic agents, and radiosensitizers. The review is a synthesis of the basic biophysical biomarker of boron based therapeutics, clinical evidence and future technological advances. The boron neutron capture therapy (BNCT) has received clinical approval in Japan to treat head and neck recurrent malignancies but its overall translational utility is limited due to a lack of optimal selectivity of the delivery agents of boron and lack of in-vivo real-time dosimetry. Such areas of limitation are fertile grounds of innovation particularly using third-generation nanocarriers and advanced imaging modalities. More importantly, the scientific revival of boron therapeutics is discussed in its specific geopolitical context. Known as a commanding figure in the world in terms of its boron reserves, Türkiye is a strategic resource, which offers an opportunity of historic proportions to change away as a supplier of raw materials to be among the global pioneers of high-value boron-based medicine. In addition, the review includes a bibliometric evaluation of 26 original research sources (published in Turkish institutions, (2004-2026) which thereby depicts a more advanced shift in a polymer chemistry-based foundation to intricate theranostics and reactor physics. Some strategic perspective of using this resource hegemony is finally looked upon in the review with actionable directions toward translation advancement.

Keywords

• Boron Neutron Capture Therapy
• Medical Physics
• Biophysics
• Boron Delivery Agents
• Accelerator Neutron Sources
• Nanomedicine

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