Boron neutron capture therapy shows promise for deadly brain tumors

Malignant gliomas are among the deadliest brain cancers, with limited treatment options and poor survival. A new comprehensive review analyzes decades of global clinical data on boron neutron capture therapy (BNCT), a targeted radiation approach. The study finds consistent survival benefits across multiple tumor types and treatment settings. By synthesizing evidence from accelerator- and reactor-based studies worldwide, the work highlights BNCT's renewed clinical promise and outlines key challenges for broader adoption.

Malignant gliomas, including glioblastoma, are among the most aggressive and deadly brain tumors. Even with surgery, radiation, and chemotherapy, most patients survive little more than a year after diagnosis. For recurrent tumors, treatment options are extremely limited, and outcomes are often poor. This harsh reality has fueled growing interest in alternative therapies that can more precisely target cancer cells while sparing healthy brain tissue.

Boron neutron capture therapy (BNCT), a targeted radiotherapy has emerged as a potential technique for treatment of recurrent tumors by precise eradication of malignant tumor cells while sparing adjacent healthy tissues. This therapy involves a boron-containing drug that preferentially accumulates in tumor cells. The tumor is then exposed to a neutron beam. When neutrons interact with boron atoms inside cancer cells, they trigger a nuclear reaction that releases high-energy particles capable of destroying the tumor, while minimizing damage to surrounding tissue.

In a new study, a team of researchers led by Dr. Chunhong Wang from Peking University, China, and Dr. Zhigang Liu and Dr. Xiao Xu from Southern Medical University, China, provide one of the most comprehensive reviews to date of BNCT for malignant gliomas. Rather than reporting results from a single clinical trial, the team systematically reviewed decades of clinical studies conducted worldwide to evaluate BNCT's effectiveness, safety, and clinical potential. The study was published in Volume 9 of the journal Research on 8 January 2026.

"BNCT is fundamentally different and advantageous compared to conventional radiochemotherapy. It can eliminate both proliferative and quiescent and hypoxic tumor cells. In addition, BNCT destroys only those cells that have absorbed the neutron capture agent and are irradiated by neutrons. Moreover, the drug involved has low toxicity and minimal side effects," says Dr. Wang.

To conduct their analysis, the researchers examined clinical trials and case series involving patients with newly diagnosed, recurrent, or treatment-resistant malignant gliomas. These studies used different boron drugs, most commonly boronophenylalanine, and a variety of neutron sources, including nuclear reactors and more recent accelerator-based systems. The team assessed outcomes such as overall survival, progression-free survival, and tumor response. Despite differences in study design and treatment protocols, the findings revealed a consistent trend. Across multiple studies and regions, BNCT was associated with survival outcomes that compared favorably with standard treatments, particularly in patients with recurrent tumors. In several reports, median survival times exceeded expectations for this patient group, and a subset of patients achieved long-term survival.

"Preliminary clinical data indicate that BNCT treatment may extend the overall survival and improve the quality of life for patients with glioblastoma, head and neck carcinoma, meningioma, malignant melanoma, and liver cancer," says Dr. Liu.

The review also highlights BNCT's potential beyond glioblastoma. Positive outcomes were reported in other high-grade brain tumors, including anaplastic gliomas and malignant meningiomas, suggesting that the therapy may have broader clinical applications.

One key factor driving renewed interest in BNCT is technological progress. Early BNCT treatments depended on nuclear reactors, while in recent years, accelerator-based neutron sources have been developed, making hospital-based BNCT more feasible and accessible for patients.

While clinical trials have evaluated the potential of BNCT across various tumor types, many of the reviewed studies involved small sample sizes, and treatment protocols varied widely in terms of boron compounds and neutron dose. These differences affected direct comparison of results across studies.