The edinburgh experience of fast neutron therapy

Clinical evaluation of neutron beam therapy. Current results and prospects, 1983

“…The impact of the new modality is fourfold: (1) neutrons expand the scope of radiation therapy to include intrinsically radioresistant tumors previously considered unsuitable for irradiation; (2) where tumor ablation can be accomplished by irradiation alone, new procedures for conservative or corrective surgery become feasible; (3) with improved control of local disease, neutrons expand the role of elective chemotherapy for the prevention or retardation of metastatic growth; and (4) neutrons expand the range of options available to the cancer patient who may wish to consider conservative treatment with the new modality as a possible alternative to radical surgery.…”

“…Protocols were largely nonrandomized and included both mixed beam studies (neutrons + photons) and neutrons alone in varying doses. In spite of wide variation in equipment, treatment technique, and philosophy, some consistent trends have been identified: (1) in general, the neutron results have been at least as good as those of the photon controls measured in terms of local control, although the incidence of significant side effects have been higher; (2) in none of the randomized studies conducted so far, largely comprising epidermoid carcinomas of the head and neck, has a clear survival advantage for neutrons over photon controls been demonstrated at a statistically significant level; (3) results with mixed beam studies have been uniformly equivocal, with marginally significant differences in favor of the experimental groups compared with the photon controls; (4) adenocarcinomas of the gastrointestinal tract (GI) tract, including tumors of the salivary gland, pancreas, stomach, and bowel, appear to be responsive to high linear energy transfer (LET) radiation; (5) nonepidermoid, radioresistant tumors (sarcoma of bone and soft tissue and melanoma) yield a consistantly high local control rate, with neutron irradiation strikingly superior to those reported with photon therapy; and (6) in the central nervous system, both normal tissues and tumors appear to be exceptionally sensitive to neutron irradiation, therapeutic ratios are small, and the prospect of cure remains remote. It is concluded that neutrons are efficacious for certain specific tumor types, but that essentially new study designs, based on nonrandomized matched case comparisons, will be required to prove the merit of the new modality.…”

The Role of Endoscopic Treatment after Radical Radiotherapy for Invasive Bladder Cancer

“…Pure squamous cancer formed 5.5% of all invasive tumours during this period but has been excluded from this analysis. Twenty-nine patients treated with neutron irradiation were excluded because of the particular problems associated with this treatment (Duncan et al, 1982). Two patients who were younger than average and had metastases at presentation were managed by cytotoxic chemotherapy (Carmichael et al, 1985).…”

Radioterapia hadronowa w Krakowie — przeszłość, teraźniejszość i przyszłość

“…Kliniczne wskazania do radioterapii neutronowej obejmowały przede wszystkim nowotwory o małej promieniowrażliwości: nowotwory ślinianek, nieoperacyjne przerzuty raka płaskonabłonkowego do węzłów chłonnych, miejscowo zaawansowany rak gruczołu krokowego, mięsaki tkanek miękkich oraz nieoperacyjne wznowy raka piersi po mastektomii [3,[10][11][12][13][14][15][16].…”