A Review of Planned, Ongoing Clinical Studies and Recent Development of BNCT in Mainland of China

SIMPLE SUMMARY: Boron neutron capture therapy (BNCT) is an innovative radiation therapy that shows promise in treating certain types of cancer. Recent advancements in BNCT have focused on developing compact neutron source devices and more effective boron agents in mainland China. This paper highlights the successful transition of two compact neutron source devices from research to clinical trials, with plans underway for their registration as medical devices. Moreover, accelerator-based neutron source devices in construction and the development of boron agents are introduced. The challenges facing BNCT in practice in mainland China as a widely accepted and implemented cancer treatment are analyzed. ABSTRACT: Boron neutron capture therapy (BNCT) is a promising cancer treatment modality that combines targeted boron agents and neutron irradiation to selectively destroy tumor cells. In mainland China, the clinical implementation of BNCT has made certain progress, primarily driven by the development of compact neutron source devices. The availability, ease of operation, and cost-effectiveness offered by these compact neutron sources make BNCT more accessible to cancer treatment centers. Two compact neutron sources, one being miniature reactor-based (IHNI-1) and the other one being accelerator-based (NeuPex), have entered the clinical research phase and are planned for medical device registration. Moreover, several accelerator-based neutron source devices employing different technical routes are currently under construction, further expanding the options for BNCT implementation. In addition, the development of compact neutron sources serves as an experimental platform for advancing the development of new boron agents. Several research teams are actively involved in the development of boron agents. Various types of third-generation boron agents have been tested and studied in vitro and in vivo. Compared to other radiotherapy therapies, BNCT in mainland China still faces specific challenges due to its limited clinical trial data and its technical support in a wide range of professional fields. To facilitate the widespread adoption of BNCT, it is crucial to establish relevant technical standards for neutron devices, boron agents, and treatment protocols.