Zhou Rongmiao, You Zhun, Liu Liang
Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Front Oncol. 2025 Oct 17;15:1601013. doi: 10.3389/fonc.2025.1601013. eCollection 2025.
Boron neutron capture therapy (BNCT), as an emerging binary treatment method, has shown the advantage of effectively treating tumors while sparing normal tissues, utilizing the characteristics of boron's nuclear capture and fission reactions, as well as the distinct distribution of boron delivery agents in tumor tissues and healthy tissues. Currently, numerous boron delivery agents have been developed to improve their targeting property, biocompatibility, solubility, and nuclear localization capability. The shift of neutron source from being based on nuclear reactors to being based on accelerators facilitates the conduct of clinical trials. BNCT has demonstrated promising results in treating head and neck cancers, gliomas, and skin melanomas. In addition, researches on the application of BNCT have been carried out in other tumors, such as liver cancer, lung cancer, and breast cancer. Notably, in 2020, BNCT was approved for clinical use in the treatment of unresectable locally advanced or locally recurrent head and neck cancer. Subsequently, post-marketing surveillance confirmed its safety and efficacy. Despite the progress made, BNCT still encounters substantial challenges in enhancing its efficacy. This review provides a comprehensive synthesis of the literature on BNCT over the last decade. It systematically examines the treatment's mechanism of action, the landscape of clinical research, key markers and factors influencing therapeutic efficacy, and the primary challenges and future directions for the field. The development of BNCT is impeded by several significant challenges, including the research and development of boron delivery agents, the construction of neutron sources, the management of tumor heterogeneity, the advancement of clinical translation, and the securement of economic and logistical support. These challenges can only be systematically overcome through the organic integration of technological innovation, policy support, clinical standardization, and cross-disciplinary collaboration, thereby creating a synergistic effect.
硼中子俘获疗法（BNCT）作为一种新兴的二元治疗方法，利用硼的核俘获和裂变反应特性以及硼递送剂在肿瘤组织和健康组织中的不同分布，展现出在有效治疗肿瘤的同时 sparing 正常组织的优势。目前，已开发出众多硼递送剂以改善其靶向性、生物相容性、溶解性和核定位能力。中子源从基于核反应堆向基于加速器的转变促进了临床试验的开展。BNCT 在治疗头颈部癌、神经胶质瘤和皮肤黑色素瘤方面已显示出有前景的结果。此外，也已开展了 BNCT 在其他肿瘤如肝癌、肺癌和乳腺癌中的应用研究。值得注意的是，2020 年，BNCT 被批准用于临床治疗不可切除的局部晚期或局部复发性头颈部癌。随后，上市后监测证实了其安全性和有效性。尽管取得了进展，但 BNCT 在提高疗效方面仍面临重大挑战。本综述全面综合了过去十年关于 BNCT 的文献。它系统地研究了该治疗的作用机制、临床研究概况、影响治疗效果的关键标志物和因素，以及该领域的主要挑战和未来方向。BNCT 的发展受到若干重大挑战的阻碍，包括硼递送剂的研发、中子源的建设、肿瘤异质性的管理、临床转化的推进以及经济和后勤支持的保障。只有通过技术创新、政策支持、临床标准化和跨学科合作的有机整合，系统地克服这些挑战，才能产生协同效应。 （注：“sparing”此处可能有误，推测可能是“sparing”，意为“ sparing正常组织”即“ sparing正常组织”，保留正常组织之意，但不确定原文准确表述，故按原文呈现。）
