Fast Neutron Radiotherapy: The University of Washington Experience and Potential Use of Concomitant Boost with Boron Neutron Capture

• Published in: Radiation protection dosimetry 1997-04, Vol.70 (1-4), p.471-475
• Main Authors: Stelzer, K.J., Lindsley, K.L., Cho, P.S., Laramore, G.E., Griffin (INVITED), T.W.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Combined treatment; Medical sciences; Treatment. General aspects; Tumors
• ISSN: 0144-8420; 1742-3406
• DOI: 10.1093/oxfordjournals.rpd.a031999

Well defined, randomised clinical trials have demonstrated significant advantages for fast neutron radiotherapy over photon radiotherapy in locally advanced prostate cancer (10-year survival 46% vs 29%), salivary gland tumours (10-year local/regional control 56% vs 17%), and inoperable squamous cell carcinoma of the lung (2-year survival 16% vs 3%). Fast neutron treatment of high grade brain tumours (astrocytomas) resulted in tumour sterilisation, but also caused significant brain injury. This effect was important, however, in that conventional radiation therapy, and other conventional treatments, have not demonstrated sterilisation of high grade astrocytomas at any dose. The treatment of cancer utilising 10B and its neutron capture reaction (boron neutron capture therapy, or BNCT) may have potential to be effective in brain tumours and melanoma. Recent studies at the University of Washington have demonstrated that fast neutron radiotherapy cell kill can be significantly enhanced by the boron capture reaction utilising the thermal component of our fast neutron beam. This enhancement can increase cell kill between 10 and 100 fold. The implications for concomitant BNCT/fast neutron therapy with new 10B carriers will be discussed with emphasis on high grade brain tumours.