This work aims at giving an updated report of the worldwide status of Accelerator-Based BNCT (AB-BNCT).

There is a generalized perception that the availability of accelerators installed in hospitals, as neutron sources, may be crucial for the advancement of BNCT. Accordingly, in recent years a significant effort has started to develop such machines.

A variety of possible charged-particle induced nuclear reactions and the characteristics of the resulting neutron spectra are discussed along with the worldwide activity in suitable accelerator development.

Endothermic ⁷Li(p,n)⁷Be and ⁹Be(p,n)⁹B and exothermic ⁹Be(d,n)¹⁰B are compared. In addition to having much better thermo-mechanical properties than Li, Be as a target leads to stable products. This is a significant advantage for a hospital-based facility. ⁹Be(p,n)⁹B needs at least 4.5 MeV bombarding energy to have a sufficient yield, while ⁹Be(d,n)¹⁰B can be utilized at about 1.4 MeV, implying the smallest possible accelerator. This reaction operating with a thin target can produce a sufficiently soft spectrum to be viable for AB-BNCT. The machines considered are electrostatic single ended or tandem accelerators or radiofrequency quadrupoles plus drift tube Linacs.

⁷Li(p,n)⁷Be provides one of the best solutions for the production of epithermal neutron beams for deep-seated tumors. However, a Li-based target poses significant technological challenges. Hence, Be has been considered as an alternative target, both in combination with (p,n) and (d,n) reactions. ⁹Be(d,n)¹⁰B at 1.4 MeV, with a thin target has been shown to be a realistic option for the treatment of deep-seated lesions.