Advances in Clinical Trials of Boron Neutron Capture Therapy

Boron neutron capture therapy (BNCT) is a targeted radiotherapy technique that enables dual targeting at the physico-biological level. Efficient neutron sources and specific boron carriers are essential for successful treatment. By exploiting the ¹⁰B(n,α)⁷Li nuclear reaction, the BNCT enables precise eradication of ¹⁰B-loaded tumor malignant cells while sparing adjacent healthy tissues, rendering it particularly advantageous for treating invasive or radioresistant recurrent tumors. Numerous clinical trials related to BNCT have focus on evaluating the safety and efficacy of treating glioblastoma, head and neck carcinoma, meningioma, malignant melanoma, and liver cancer. Preliminary studies have shown that BNCT treatment may extend the overall survival (OS) and improve the quality of life for patients with these cancers. Additionally, the scope of BNCT clinical trials has expanded to other tumor types, such as lung cancer, breast cancer, extramammary Paget's disease, osteosarcoma, clear cell sarcoma, malignant peripheral nerve sheath tumor, angiosarcoma, thyroid cancer, recurrent chordoma, and gastrointestinal malignancies. This review provides a comprehensive overview of BNCT clinical trials, covering the therapeutic principles of BNCT and the current status and outcomes of clinical trials for various types of tumors. With advancements in neutron beam quality and the development of efficient, specific boron carriers, the therapeutic efficacy of BNCT is expected to be further enhanced, and its scope of application is anticipated to expand. Looking ahead, the BNCT is expected to be integrated with other tumor treatment modalities to augment local tumor control, thereby improving patients' OS and quality of life.