An update on malignant salivary gland tumors treated with neutrons at fermilab

Gamma knife stereotactic radiosurgery for salivary gland neoplasms with base of skull invasion following neutron radiotherapy

“…NRT appears to be more effective than photon irradiation for patients having gross residual disease after surgical resections or biopsies only. [2][3][4][5][6][7][11][12][13][14][15] In our analysis of factors affecting prognosis for this group of patients, we discovered that size > 4 cm, previous irradiation, and base of skull invasion were portenders of poor local control. 8 If surgical resection is possible to reduce the burden of disease, we currently recommend that approach, however, as is often the case with tumors invading the base of skull, and surgical resection is avoided because of the potential for significant facial disfigurement.…”

Management of Malignant Submandibular Gland Tumors

“…Furthermore, they recommended the use of brachytherapy in the event that external beam irradiation could not be carried out. If the recurrence is deemed to be unresectable, high-dose irradiation is recommended, with the potential to use brachytherapy or fast neutron therapy in patients who were previously irradiated (97,98).…”

Optimization of Radiation Therapy for Locally Advanced Adenoid Cystic Carcinomas with Infiltration of the Skull Base Using Photon Intensity-Modulated Radiation Therapy (IMRT) and a Carbon Ion Boost

“…Since experimental studies by Batterman et al in lung metastasis of adenoid cystic carcinomas revealed RBE (relative biological effectiveness) values as high as 8 after irradiation with fast neutrons [1], several prospective clinical trials have been carried out investigating fast neutron radiotherapy in adenoid cystic carcinomas [2,12,20,21,25]. In all studies there was observed a significantly higher local tumor control rate after high-LETRT compared to low-LET radiation therapy.…”

“…The main disadvantage of fast neutron therapy was the high rate of severe side effects. The overall rate for severe late toxicity ranged from 13% to 23% [25]. As late effects mainly occurred outside the target volume, more conformal radiation therapy is likely to reduce late toxicity to non-target tissue [4,30].…”