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Updated: Oct 12, 2025

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
Technical note: Monte Carlo study of the mechanism of proton-boron fusion therapy
Henry J Meyer1,2, Uwe Titt1,3, Radhe Mohan1
1Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Purpose:
Proton beam therapy has been found to have enhanced biological effectiveness in targets that contain the boron isotope 11 B, with the alpha particles resulting from the p + 11 B → 3α reaction being hypothesized as the mechanism; in this study, we aimed to elucidate the causes of the enhanced biological effectiveness of proton-boron fusion therapy by performing a detailed Monte Carlo study of the p + 11 B → 3α reaction in a phantom geometry.
Methods:
We utilized the Geant4 toolkit to create Monte Carlo particle physics simulations. These simulations consisted of a proton beam with a range 30 mm, creating a Spread-Out Bragg Peak with a modulation width of 10 mm, directed into a water phantom containing a region of boron material. Energy deposition, particle energy, and particle fluence were scored along the path of the beam and grouped by particle species. The scoring was performed using a series of cylindrical volumes with a radius of 2.5 mm and depth of 0.1 mm, constructed such that the depth was parallel to the proton beam. Root was then used to perform the data analysis.
Results:
Our simulations showed that the dose delivered by alpha particles produced by p + 11 B → 3α was several orders of magnitude lower than the dose delivered directly by protons, even when the boron uptake region was comprised entirely of natural boron or pure 11 B.
Conclusions:
Our findings do not support the theory that an alpha particle-based mechanism is responsible for the enhanced biological effectiveness of proton-boron fusion therapy. We conclude that any enhanced biological effect seen in experimental studies was not caused by fusion reactions between protons and 11 B nuclei. However, it is necessary to reproduce the past experiments that indicated significant dose enhancement.
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