Side effects of boron neutron capture therapy

Boron neutron capture therapy (BNCT) is an innovative cancer treatment modality that selectively eliminates tumor cells while sparing normal tissues. Clinical studies have explored its application across various malignancies, including malignant gliomas, meningiomas, pediatric tumors, head and neck cancers, and melanomas. However, despite its therapeutic potential, BNCT is associated with various adverse effects that differ depending on the tumor type, neutron source, boron delivery agent, and treatment protocol. These adverse reactions pose significant challenges to the broader clinical implementation of this approach. This review systematically examines the adverse effects of BNCT observed in clinical studies, focusing on their underlying mechanisms, contributing factors, and tumor-specific variations. Additionally, it highlights current strategies for managing and preventing these effects and emphasizes the need for further research to address unresolved challenges. This article aims to provide comprehensive insights into the adverse effects of BNCT, supporting the development of safer and more effective treatment protocols and ultimately advancing their role in precision oncology.