Recently, progress in technology for accelerator-based neutron sources has increased attention regarding boron neutron capture therapy (BNCT). BNCT is a type of radiotherapy that combines neutrons and boron drugs and is expected to be used in the treatment of refractory and recurrent cancers. Owing to the need for high-intensity neutrons in treatment, compact accelerator-based neutron sources applicable to BNCT are being developed worldwide. These current projects utilize cyclotrons, linear accelerators, and electrostatic accelerators as accelerators for BNCT devices. Beryllium and lithium are the main target materials for neutron generation. The accelerators for BNCT device are required to accelerate charged particles with an average current ranging from a few milliamperes to a few tens of milliamperes in order to generate neutrons of sufficient intensity for the treatment. Moreover, the target systems require technologies and mechanisms that can withstand the large heat load produced by high-power beam irradiation and prevent blistering. This review outlines and explains the accelerator neutron sources for BNCT and the requirements for the components of each device, such as the accelerator, target material, and beam shaping assembly. In addition, various development projects for accelerator-based BNCT devices worldwide are introduced.

To perform boron neutron capture therapy (BNCT), a type of radiotherapy, a neutron source as a treatment device and peripheral devices such as a treatment planning system (TPS), patient setting device, and neutron monitor are needed. In particular, a TPS is indispensable software in radiotherapy and enables the simulation of a treatment with neutron beam irradiation with a patient’s three-dimensional model based on the patient’s medical images. In addition, the system supports the determination of suitable irradiation conditions for each patient. The patient setting device works to realize the irradiation conditions determined during treatment planning in the actual irradiation room just before irradiation.

Although proton radiotherapy is a promising new approach for cancer patients, functional interference is a concern for patients with implantable cardioverter defibrillators (ICDs). The purpose of this study was to clarify the influence of secondary neutrons induced by proton radiotherapy on ICDs. The experimental set-up simulated proton radiotherapy for a patient with an ICD. Four new ICDs were placed 0.3 cm laterally and 3 cm distally outside the radiation field in order to evaluate the influence of secondary neutrons. The cumulative in-field radiation dose was 107 Gy over 10 sessions of irradiation with a dose rate of 2 Gy/min and a field size of 10 × 10 cm². After each radiation fraction, interference with the ICD by the therapy was analyzed by an ICD programmer. The dose distributions of secondary neutrons were estimated by Monte-Carlo simulation. The frequency of the power-on reset, the most serious soft error where the programmed pacing mode changes temporarily to a safety back-up mode, was 1 per approximately 50 Gy. The total number of soft errors logged in all devices was 29, which was a rate of 1 soft error per approximately 15 Gy. No permanent device malfunctions were detected. The calculated dose of secondary neutrons per 1 Gy proton dose in the phantom was approximately 1.3-8.9 mSv/Gy. With the present experimental settings, the probability was approximately 1 power-on reset per 50 Gy, which was below the dose level (60-80 Gy) generally used in proton radiotherapy. Further quantitative analysis in various settings is needed to establish guidelines regarding proton radiotherapy for cancer patients with ICDs.