Results of two randomised clinical trials of neutron therapy in rectal adenocarcinoma

Duncan, W.; Arnott, S.J.; Jack, W; Orr, J.A.; Kerr, G.R.; Williams, J. Raymond

doi:10.1016/s0167-8140(87)80242-6

Cited by 36 publications

(10 citation statements)

References 4 publications

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“…This was quite striking in some patients and may have contributed to their symptoms. The severe subcutaneous fibrosis reported following neutron therapy with early equipment [10,11] and Delatte et al [12] have noted preferential neutron energy absorption in fat, which may contribute to this striking subcutaneous finding.…”

Section: Discussionmentioning

confidence: 99%

Musculoskeletal complications of neutron therapy for prostate cancer

Soulen

Romero

Chuba

et al. 1997

Radiat. Oncol. Investig.

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The purpose of this study was to investigate the cause of hip complaints following conformal neutron therapy delivered by opposed lateral and oblique anterior ports to treat prostate cancer. Twenty‐seven patients with hip complaints following neutron or mixed neutron and photon therapy for prostate cancer had 34 magnetic resonance imaging (MRI) studies 3–39 (mean 15.3) months following treatment; for comparison, 13 similarly treated patients without hip complaints were imaged 1–32 (mean 13.8) months post‐treatment; 25/40 imaged patients received concurrent nonsteroidal hormone therapy. Coronal and axial images of the hips/pelvis were obtained utilizing T1 weighted spin echo and fat suppressed inversion recovery (STIR) sequences. Signal amplitude (SA) of involved muscles was measured on the STIR images and normalized to that of the psoas outside the treatment field. Hip complaints ranged from mild soreness or motion limitation to severe pain and limitation of ambulation; presence and severity of symptoms (sx) were significantly related to neutron dose (P = 0.020 and 0.0001) but not to hormone therapy (each P > 0.17). Normalized SA of the obturator muscles differed significantly with neutron dose (P = 0.013), the presence, and the severity, of sx (P = 0.0002 and 0.0007); estimated extent of abnormal muscle also differed significantly with neutron dose (P = 0.039), presence, and severity, of sx (P = 0.00004 and 0.0007); [hormone treatment had a profound effect on SA (P = 0.0001) and extent (P = 0.005) which was independent of sx (P = 0.10 and 0.14, respectively) and neutron dose (P = 0.33 and 0.32, respectively)]. Subcutaneous changes localized lateral to the greater trochanter were seen in all, and edema of the subjacent gluteus muscles in many, symptomatic hips; only 4/13 asymptomatic hips showed subcutaneous changes, 6 had mild gluteus edema. Avascular necrosis of the femoral head was seen in 5 symptomatic hips, with marked acetabular necrosis in 3 of these; small joint effusions were seen in 8 symptomatic hips; asymptomatic hips had no significant bone or joint abnormalities. Neutron therapy for prostate cancer designed to spare the rectum results in significant dose‐dependent, musculoskeletal complications which are well demonstrated by MRI. SA abnormalities of irradiated muscle correlate significantly with neutron dose and both presence and severity of hip sx. Protocol modifications have been implemented to reduce these complications. MRI provides an objective means to assess both complications and the success of new protocols in ameliorating them. Concurrent hormone therapy has a profound effect on muscle changes on MRI which is independent of neutron dose and sx. Radiat. Oncol. Invest. 5:81–91, 1997. © 1997 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Musculoskeletal complications of neutron therapy for prostate cancer

Soulen

Romero

Chuba

et al. 1997

Radiat. Oncol. Investig.

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“…Investigational radiation therapy approaches using neutron sources [80] and hyperthermia [81][82][83][84] have been examined. None have shown a clear advantage compared with conventional pelvic radiation therapy.…”

Section: Alternative Radiation Therapy Approachesmentioning

confidence: 99%

Combined modality therapy of resectable rectal cancer: current approaches

Minsky

2004

Tech Coloproctol

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There are two conventional treatments for clinically resectable rectal cancer. First is surgery and, if the tumor is in stage T3 or N1-2, this is followed by postoperative combined modality therapy. The second is preoperative combined modality therapy followed by surgery and postoperative combined modality therapy if the tumor is classified at ultrasound as uT3-4 or N+. A number of new chemotherapeutic agents have been developed for the treatment of patients with colorectal cancer. Ongoing phase I and II trials are examining the use of these new chemotherapeutic agents in combination with pelvic radiation therapy, most commonly in the preoperative setting; early results suggest that the complete response rates are higher. Based on results from phase I and II trials, the standard regimen for patients who receive combined modality therapy is continuous infusion 5-fluorouracil (5-FU) and pelvic radiation. Regimens using CPT-11 or oxaliplatin-based combined modality therapy plus either continuous infusion 5-FU or capecitibine are under active development.

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“…Battermann u. Breur [2,3] berichten aus Amsterdam ª zwei Studien zur Neutronentherapie von Rektumtumoren. In Edinburgh befa6ten sich Duncan et al [10] von 1978 bis 1984 mit diesem Thema. Etwa zur gleichen Zeit liefen Studien in Hamburg unter der Leitung von Franke et al [18,19] an.…”

Section: Diskussionunclassified

“…Deshalb wurde angenommen, dal3 die Neutronenbestrahlung einen Vorteil in der Behandlung dieser Tumoren bietet [2,5,10,12,15,18]. Deshalb wurde angenommen, dal3 die Neutronenbestrahlung einen Vorteil in der Behandlung dieser Tumoren bietet [2,5,10,12,15,18].…”

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