Evolution of Particle Radiotherapy: From Physical to Dual Targeting in Precision Medicine

tumor-specific boron-10 agents) with cellular-scale physical precision (realized by neutron-irradiation-triggered, locally confined high LET particles). This review delineates the latest progress in particle radiotherapy, specifically highlighting the crucial transition from the established physical targeting of PT and CIRT to the burgeoning dual-targeting innovation of BNCT. We provide an in-depth analysis of mechanistic principles, technological advancements in accelerator-based sources, the pharmacological evolution of boron delivery systems, and the resulting clinical applications. Future directions for the entire particle radiotherapy field center on reducing operational costs, optimizing therapeutic accuracy, conducting robust randomized trials, and exploring synergistic therapies. Critically, BNCT, with its unique dual-targeting mechanism, represents a potentially transformative precision therapy with significant potential for intractable malignancies.