Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Neutron-capture therapy in a case of cerebellar sarcoma treated initially with X-radiation

A clinical and histological study

  • 39 Accesses

  • 4 Citations


This paper deals with a girl who at birth had a large retroauricular mass diagnosed clinically as hemangioma. It responded well to X-ray therapy. When she was 11 years old, a sarcoma was removed from the cerebellum. No evidence could be found that the sarcoma had originated from the retroauricular tumor. After the use of nitrogen mustard locally and after three courses of X-ray therapy to the tumor over a period of 9 1/2 months — a total radiation dose of approximately 7,953 r — the patient was growing moribund. During 4 neutron-capture treatments, which were directed chiefly toward the suboccipital region, striking improvement occurred — to such an extent that the patient was able for a time to sit up in a wheelchair and converse. As a result of the therapy, all tumor which had spread suboccipitally and into the neck vanished, as did also virtually all tumor in the dorsal third of the cerebellum, i.e., in the region receiving the largest concentration of thermal neutrons. In the middle third of the cerebellum large and small tumor aggregates, some of them calcified, were necrotic and were walled off by hyperplastic connective tissue. In the ventral third of the cerebellum, in a region presumably out of the range of an effective concentration of thermal neutrons, the tumor grew unimpeded.

Evidence indicated that the sarcoma in our case originated in the vascular sheath, chiefly about vessels in the granular layer of the cerebellum.

Life was prolonged approximately 8 months by the neutron-capture therapy.


Ce cas est celui d'une enfant qui présentait à la naissance une large masse rétroauriculaire que le diagnostique clinique identifiait comme étant un hémangiome. La radio thérapie eut de très bons résultats. A onze ans on pratiqua l'ablation d'un sarcome cérébelleux qui ne semblait pas avoir été causé par la tumeur rétroauriculaire. Après traitement à moutarde nitrogénée et après trois appliquations de rayon X s'échelonnants pendant neuf mois et demi-soit une dose de radiation d'environ 7,953 r — son état s'aggrava. Pendant quatre traitements de «neutron capture», dirigés principalement sur la région sous-occipitale, on remarqua une amélioration spectaculaire, la malade pouvant s'asseoir et étant même capable de converser pendant quelque temps. Après ce traitement, la tumeur qui s'étendait dans la région sous-occipitale et dans la cou disparut, ainsi que presque toute la tumeur qui se trouvait dans le tiers dorsal du cervelet particulièrement dans la région la plus proche de l'aire sous-occipitale. Dans le tiers moyen cérébelleux on trouva également des agrégats de tumeurs plus ou moins grands, dont quelques-uns calcifiés, qui étaient isolés par un tissu conjonctif hyperplasique. Dans le tiers ventral du cervelet la tumeur ne cessa de croître dans la région non-irradiée par les neutrons. La tumeur était un sarcome d'origine périvasculaire située principalement dans la couche réticulaire cérébelleuse. La vie de la malade fut prolongée d'environ huit mois par le traitement de «neutron capture».

This is a preview of subscription content, log in to check access.


  1. Abbott, K. H., andJ. W. Kernohan: Primary sarcomas of the brain. Review of the literature and report of twelve cases. Arch. Neurol. Psychiat. (Chicago)50, 43–66 (1943).

  2. Bailey, P., D. N. Buchanan andP. C. Bucy: Intracranial tumors of infancy and childhood, pp. 51, 90–96, 104–107. Chicago: Univ. Chicago Press 1939.

  3. Berg, N. O., andM. Lindgren: Time-dose relationship and morphology of delayed radiation lesions of the brain in rabbits. Acta radiol. (Stockh.), Suppl. 167, 42–118 (1958).

  4. Bogaert, L. van, etJ. Hermanne: Aspects cliniques et pathologiques des radionécroses cérébrales chez l'homme. Ann. Méd.49, 14–44 (1948).

  5. Cervos-Navarro, J., andV. Menozzi: Das Verhalten des Mesenchyms bei Hirntumoren. Psychiat. Neurol. jap.61, 371–392 (1959).

  6. Conn, H. L., Jr.,B. B. Antal andL. E. Farr: The effect of large intravenous doses of sodium borate on the human myocardium as reflected in the electrocardiogram. Circulation12, 1043–1046 (1955).

  7. Dastur, D. K., andG. Sinh: Toxic iron and the nervous system. Siderotic necrosis of spinal root sheaths, ganglia and nerve, an siderosis of central nervous border-zones, in a case of “pinealoma”. J. Neurosurg. (In press).

  8. Farr, L. E.: The experimental application of neutron capture therapy to glioblastoma multiforme. Acta Un. int. Cancr.11, 500–503 (1955).

  9. —: Les applications médicales des réacteurs nucléaires. Brux. méd.37, 843–858 (1957a).

  10. —: Present progress in neutron capture therapy. Acta radiol. interamer.7, 65–74 (1957b).

  11. —,J. S. Robertson andE. Stickley: Physics and physiology of neutron-therapy. Proc. nat. Acad. Sci. (Wash.)40, 1087–1093 (1954a).

  12. ———,H. J. Bagnali, O. D. Easterday andW. Kahle: Recent advances in neutron capture therapy. In Progress in nuclear energy, VII, Medical sciences, vol. 2, pp. 128–138. London: Pergamon Press 1959.

  13. —,W. H. Sweet, J. S. Robertson, C. G. Foster, H. B. Locksley, D. L. Sutherland, M. L. Mendelsohn andE. E. Stickley: Neutron capture therapy with boron in the treatment of glioblastoma multiforme. Amer. J. Roentgenol.71, 279–291 (1954b).

  14. Garcin, R., etJ. Lapresle: Sur un cas de surcharge ferrique du système nerveux central. Rev. neurol.97, 417–432 (1957).

  15. Godwin, J. T., L. E. Farr, W. H. Sweet andJ. S. Robertson: Pathological study of eight patients with glioblastoma multiforme treated by neutron capture therapy using boron-10. Cancer (Philadelph.)8, 601–615 (1955).

  16. Haymaker, W., L. E. Farr, Y. L. Yamamoto, W. Calvo, P. Yakovlev, W. Kahle, O. Stochdorph andS. W. Lippincott: Neutron-capture therapy in intracranial gliomas and sarcomas. Neuropathological study of 16 cases. J. Neuropath. exp. Neurol. (in preparation).

  17. Jacob, H., andF. M. Goachet: Hemosiderosis meningoencefálica, crónica, progressiva, necrotizante. Acta neuropsiquiát. argent.5, 128–142 (1959).

  18. Javid, M., G. L. Brownell andW. H. Sweet: The possible use of neutron-capturing isotopes such as boron-10 in the treatment of neoplasms. II. Computation of the radiation energies and estimates of effects in normal and neoplastic brain. J. clin. Invest31, 604–610 (1952).

  19. Kindt, P.-H.: Röntgenschäden nach Bestrahlung medianer Hirngewächse. Arch. Psychiat. Nervenkr.191, 55–72 (1953).

  20. Lippincott, S. W., Y. L. Yamamoto andL. E. Farr: Radiation effects of neutron-capture therapy on a malignant vascular neoplasm of the cerebellum. Histopathological observations. A.M.A. Arch. Path.69, 44–54 (1960).

  21. Locksley, H. B., andL. E. Farr: The tolerance of large doses of sodium borate intravenously by patients receiving neutron capture therapy. J. Pharmacol. exp. Ther.114, 484–489 (1955).

  22. Lund, O.-E.: Histologische Veränderungen an Gliomen nach Einwirkung ionisierender Strahlen (radioaktive Isotopen), pp. 229–234, IIId Congr Neuropath., Brussels, 1957.

  23. Lyman, R. S., P. S. Kupalov andW. Scholz: Effects of roentgen rays on the central nervous system. Results of large doses on the brains of adult dogs. Arch. Neurol. Psychiat. (Chicago)29, 56–87 (1933).

  24. Markiewicz, T.: Über Spätschädigungen des menschlichen Gehirns durch Röntgenstrahlen. Z. ges. Neurol. Psychiat.152, 548–568 (1935).

  25. Noetzel, H.: Diffusion von Blutfarbstoff in der inneren Randzone und äußeren Oberfläche des Zentralnervensystems bei subarachnoidaler Blutung. Arch. Psychiat. Nervenkr.111, 129–138 (1940).

  26. Pennybacker, J., andD. S. Russell: Necrosis of brain due to radiation therapy. Clinical and pathological observations. J. Neurol. Neurosurg. Psychiat.11, 183–198 (1948).

  27. Rosenthal, P.: Siderose der Randzonen des Zentralnervensystems. Dtsch. Z. Nervenheilk.178, 431–472 (1958).

  28. Russell, D. S., andL. J. Rubinstein: Pathology of tumors of the nervous system, pp. 8,60. London: Arnold 1959.

  29. —,C. W. Wilson andK. Tansley: Experimental radio-necrosis of the brain in rabbits. J. Neurol. Neurosurg. Psychiat.12, 187–195 (1949).

  30. Scholz, W.: Experimentelle Untersuchungen über die Einwirkung von Röntgenstrahlen auf das reife Gehirn. Z. ges. Neurol. Psychiat.150, 765–785 (1934).

  31. —, Über die Empfindlichkeit des Gehirns für Röntgen- und Radiumstrahlen. Klin. Wschr.14, 189–193 (1935).

  32. —,E.-G. Ducho u.A. Breit: Experimentelle Röntgenspätschäden am Rückenmark des erwachsenen Kaninchens. Ein weiterer Beitrag zur Wirkungsweise ionisierender Strahlen auf das zentralnervöse Gewebe. Psychiat. Neurol. jap.61, 417–442 (1959).

  33. —, andY. K. Hsü: Late damage from roentgen irradiation of the human brain. Arch. Neurol. Psychiat. (Chicago)40, 928–936 (1938).

  34. Soloway, A. H. andD. S. Gordon: Evaluation of two boron-containing drugs for use in the proposed neutron-capture irradiation of gliomas. J. Neuropath. exp. Neurol.19, 415–420 (1960).

  35. Sunderman, F. W., andW. Haymaker: Hypothermia and elevated serum magnesium in a patient with facial hemangioma extending into the hypothalamus. Amer. J. med. Sci.213, 562–571 (1947).

  36. Vogel, F. S., andJ. E. Pickering: Demyelinization induced in the brains of monkeys by means of fast neutrons. Pathogenesis of the lesion and comparison with the lesions of multiple sclerosis and Schilder's disease. J. exp. Med.104 435–442 (1956).

  37. Zimmerman, H. M.: In:Zimmerman, H. M., andR. D. Adams: Seminar on diseases of nervous tissue and muscle. Amer. Ass. Clin Pathologists, Nov. 8, 1958.

  38. —,M. G. Netsky andJ. Berkmann Primary cerebellar sarcoma. Trans. Amer. neurol. Ass.76, 84–86 (1951).

  39. —— andL. M. Davidoff: Atlas of tumors of the nervous system, pp. 104–107. Philadelphia: Lea and Febiger 1956.

  40. Zülch, K. J.: Biologie und Pathologie der Hirngeschwulste. In: Handbuch der Neurochirurgie (H. Olivecrona andW. Tönnis, eds.), Bd. 3, S. 468–493. Heidelberg: Springer 1956

  41. — Über die Strahlensensitivität der Hirngeschwülste und die sogenannte Strahlen-Spätnekrose des Hirns. Dtsch. med. Wschr.85, 298–309 (1960).

Download references

Author information

Additional information

With 20 Figures in the Text

Read at the 36th Annual Meeting of the American Association of Neuropathologists, Boston, June 12, 1960.

Research supported by the United States Atomic Energy Commission.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Farr, L.E., Haymaker, W., Calvo, W. et al. Neutron-capture therapy in a case of cerebellar sarcoma treated initially with X-radiation. Acta Neuropathol 1, 34–55 (1961).

Download citation


  • Sarcoma
  • Hemangioma
  • Thermal Neutron
  • Granular Layer
  • Neutron Capture