Treatment of Salivary Gland Neoplasms With Fast Neutron Radiotherapy

Douglas, James; Koh, Wui Jin; Austin-Seymour, Mary; Laramore, George E.

doi:10.1001/archotol.129.9.944

Cited by 126 publications

(112 citation statements)

References 25 publications

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“…Huber found in his comparison of neutron therapy versus mixed beam versus photon therapy that although the complication rates were higher with neutron therapy, 5 of 27 (17%) versus 2 of 21 (10%) versus 1 of 25(4%) respectively, this was not significant [19]. Douglas had a 6 year actuarial Grade 3 and 4 toxicity of 10% [17]. There was no significant difference in complication rates between the different dose and fractionation groups.…”

Section: Discussionmentioning

confidence: 95%

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Malignant salivary gland tumours: Can fast neutron therapy results point the way to carbon ion therapy?

Stannard

Vernimmen

Carrara

et al. 2013

Radiotherapy and Oncology

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Stannard, C. et al. (2013). Malignant salivary gland tumours: Can fast neutron therapy results point the way to carbon ion therapy? Radiotherapy and Oncology, The increasing number of hadron therapy centres around the world and their use of carbon ion beams have resulted in a growing interest in high-linear energy transfer (LET) radiotherapy. Carbon ions combine the advantages of high-LET radiation with the superior ballistic properties of charged particles. The most commonly used high-LET therapy to date is neutron therapy. The rationale for using it for salivary gland tumours is based on Battermann's observations of growth delay of pulmonary metastases treated with neutrons relative to cobalt-60 radiation [1]. He derived a relative biological effect (RBE) of 8 for fractionated therapy to adenoid cystic carcinoma metastases compared with 3 for most normal tissues, implying a significant therapeutic gain for salivary gland tumours. The safe application of high-LET hadron therapy requires biologically driven treatment planning that has to be based on clinical data. We contribute to this

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Section: Discussionmentioning

confidence: 95%

“…Subsequent results from Seattle have shown a 59% LRC rate and 67% cause specific survival (CSS) at 6 years [17] and 76.5% LC and 68.2% CSS at 7 years in major salivary gland tumours, the majority of which had macroscopically resected disease [18]. Huber has shown a 75% 5-year LCR rate for advanced adenoid cystic carcinomas [19].…”

Section: Discussionmentioning

confidence: 99%

Malignant salivary gland tumours: Can fast neutron therapy results point the way to carbon ion therapy?

Stannard

Vernimmen

Carrara

et al. 2013

Radiotherapy and Oncology

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“…LC was also significantly improved by the application of high-precision techniques, dose-escalation and high linear energy transfer radiation [7,[33][34][35][36]. Both IMRT and FSRT provide better LC than conventional radiotherapy techniques, achieving 3-year progression-free survival (PFS) rates of 38% [37].…”

Section: Malignant Salivary Gland Tumours: Adenoid Cystic Carcinomamentioning

confidence: 99%

“…Both IMRT and FSRT provide better LC than conventional radiotherapy techniques, achieving 3-year progression-free survival (PFS) rates of 38% [37]. The highest LC rates achieved to date, at 75-100% [35,36], were achieved by neutron radiation, albeit at the cost of significant late toxicity.…”

Section: Malignant Salivary Gland Tumours: Adenoid Cystic Carcinomamentioning

confidence: 99%

Review of clinical experience with ion beam radiotherapy

Jensen

Münter²,

Debus³

2011

BJR

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ABSTRACT. The article describes both the early development of oncology as a core discipline at the University of Heidelberg Hospital and the first steps towards ion beam treatment, from the pilot project carried out in co-operation with the Gesellschaft fü r Schwerionenforschung Darmstadt to the initial start-up of clinical service at the Heidelberg Heavy Ion Centre (HIT). We present an overview, based on data published in the literature, of the available clinical evidence relating the use of ion beam therapy to treat major indications in active particle centres. A rationale for the use of particle therapy in each of these indications is given. In view of the limited availability of data, we discuss the necessity to conduct clinical trials. We also look forward towards the next activities to be undertaken at the HIT.

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“…In a series of 102 patients 80 treated to a median dose of 71.6 Gy with protons, the 5-year local control was 86% (median followup-6.6 years), with very low rates of ocular toxicity. The largest study 81 of fast-neutrons in salivary gland cancers reported a 6-loco-regional control and cause-specific survival of 59% and 67% respectively, with a 10% incidence of grade 3-4 late toxicity at a median follow-up of 36 months establishing the efficacy of such therapy.…”

Section: Particle-beam Therapymentioning

confidence: 99%

IMRT and IGRT in head and neck cancer: Have we delivered what we promised?

Gupta

Agarwal

Susovan

et al. 2010

Indian J Surg Oncol

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Intensity-modulated radiation therapy (IMRT) is a revolutionary new paradigm that aims at improving the therapeutic ratio by increasing the dosegradient between target tissues and surrounding normal structures thereby offering probability of better loco-regional control with decreased risk of complications. IMRT is relatively intolerant to set-up uncertainties, warranting periodic image-guidance, making Image-Guided Radiation Therapy (IGRT) a natural corollary to IMRT. There are several challenges associated with the planning, delivery, and quality assurance of the IMRT and IGRT processes that must be addressed to realize the full potential of such exciting and promising technology. Given the complexities involved, it is quite intuitive to understand that IMRT and IGRT are resource-intensive, demanding increased labor, rigour, and expenses too. Other disadvantages associated with high-precision techniques include potentially increased risk of marginal failures, decreased dose homogeneity, and an increase in total body dose with increased risk of secondary carcinogenesis. The aim of this review is to define the role of IMRT and IGRT in contemporary head and neck oncologic practice through a critical appraisal of pertinent literature. Despite relatively short follow-up and limited clinical outcomes data, the weight of evidence suggests that loco-regional control is not inferior (either comparable or even better) and toxicity lesser with IMRT resulting in potentially improved quality-oflife, prompting the widespread adoption of such technology in community practice. Ongoing clinical trials in head and neck IMRT are currently addressing issues to optimize the IMRT process, adopting functional imaging for dose-painting, and incorporating adaptive re-planning strategies to further improve outcomes.

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Treatment of Salivary Gland Neoplasms With Fast Neutron Radiotherapy

Abstract: Neuron radiotherapy is an effective treatment for patients with salivary gland neoplasms who have gross residual disease and achieves excellent local-regional control in patients without evidence of gross disease.

Cited by 126 publications

References 25 publications

Malignant salivary gland tumours: Can fast neutron therapy results point the way to carbon ion therapy?

Malignant salivary gland tumours: Can fast neutron therapy results point the way to carbon ion therapy?

Review of clinical experience with ion beam radiotherapy

IMRT and IGRT in head and neck cancer: Have we delivered what we promised?

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