Abstract
After the first European stet on neutron therapy of head and neck cancer, published by Catterall and Bewley, revealed significant advantages of neutrons over photons in 134 randomized patients, the subsequent phase II and phase III studies led to controversial results. Figures for local tumor control varied from 26–76% after 2 years to 19% after 10 years and for survival from 16–46% after 2 years to 14% after 10 years. Results of all studies were consistent in showing an increased incidence of severe late effects. Eligibility criteria with regard to the tumor stage, histology, and previous therapies of relapses varied from study to study. Also, physical treatment parameters, such as neutron energy, LET and OER, neutron and photon doses for one fraction and for the total radiotherapy were rather different. The benefit of neutron therapy in comparison with photons was low or non-existent when smaller tumor stages, such as primaries T 2 or lymph nodes N 1 were included into the trial. It increased when only T 4 tumors, recurrences or tumors persisting after conventional radiotherapy were treated and when the percentage of fixed lymph nodes increased. There was only one European study in which patients suffering from lymph node metastases of the neck had, in contrast to American data (Griffin et al. 1978), a worse prognosis after neutrons than after photon therapy (Duncan et al. 1987b). In our own phase II study on reactor neutron therapy of 100 patients suffering from relapses and persistent tumors, not yet published, 3-year survival of 21% and 3-year local control of 32% were obtained. Although this was not a randomized study, during this period all patients with equivalent tumors treated by photon therapy alone died within 2 years. In conclusion, there is no general indication for neutron therapy in squamous cell carcinoma of the head and neck, but there is a benefit of neutrons in palliative treatment of recurrences, necrotic and hypoxic primaries and lymph nodes.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Auberger T, Reuschel W, Mayr M, Kneschaurek P, Lukas P, Clasen B, Breit A (1992) Mixed-beam photon-neutron therapy in recurrences and nodal metastases of head and neck cancer. In: Breit A (ed) Advanced radiation therapy tumor response monitoring and treatment planning, Springer, Berlin Heidelberg New York, pp 803–810
Battermann JJ, Breur K (1981) Results of fast neutron teletherapy for locally advanced head and neck tumors. Int J Radiat Oncol Biol Phys 7: 1045–1050
Battermann JJ, Mijnheer BJ (1986) The Amsterdam fast neutron therapy project: a final report. Int J Radiat Oncol Biol Phys 12: 2093–2099
Catterall M, Bewley DK (1977) Second report on results of a randomized clinical trial of fast neutrons compared with X or gamma rays in treatment of advanced tumours of head and neck. Br Med J 1: 1642
Catterall M, Errington RD (1987) The implications of improved treatment of malignant salivary gland tumors by fast neutron radiotherapy. Int J Radiat Oncol Biol Phys 13: 1313–1318
Catterall M, Errington RD, Bewley D (1987) A comparison of clinical and laboratory data on neutron therapy for locally advanced tumors. Int J Radiat Oncol Biol Phys 13: 1783–1791
Duncan W (1994) An evaluation of the results of neutron therapy trials. Acta Oncol 33:299 Duncan W, Arnott SJ, Battermann JJ, Orr JA, Schmitt G, Kerr GR (1984) Fast neutrons in the treatment of head and neck cancers: the results of a multi-centre randomly controlled trial. Radiother Oncol 2: 293–300
Duncan W, Orr JA, Arnott SJ (1987a) Fast neutron therapy for squamous cell carcinoma in the head and neck region: results fo a randomized trial. Int J Radiat Oncol Biol Phys 13: 171–178
Duncan W, Orr JA, Arnott SJ, Jack WJL, Kerr GR (1987b) An evaluation of fast neutron irradiation in the treatment of squamous cell carcinoma in cervical lymph nodes. Int J Radiat Oncol Biol Phys 13: 1793–1796
Griffin TW, Laramore GE, Parker RG, Gerdes AJ, Hebard DW, Blasko JC, Groundine M (1978) An evaluation of fast neutron beam teletherapy of metastatic cervical adenopathy from squamous cell carcinomas of the head and neck. Cancer 42: 2517–2520
Griffin TW, Davis R, Hendrickson FR, Maor MH, Laramore GE (1984) Fast neutron radiation therapy for unresectable squamous cell carcinomas of the head and neck: the results of a randomized RTOG study. Int J Radiat Oncol Biol Phys 10: 2217–2221
Griffin TW, Pajak TF, Maor MH, Laramore GE, Hendrickson FR, Parker RG, Thomas FJ, Davis LW (1989) Mixed neutron/photon irradiation of unresectable squamous cell carcinomas of the head and neck: the final report of a randomized cooperative trial. Int J Radiat Oncol Biol Phys 17: 959–965
Kaul R, Hendrickson F, Cohen L (1981) Fast neutrons in the treatment of salivary gland tumors. Int J Radiat Oncol Biol Phys 7: 1667–1671
Krüll A, Schwarz R, Heyer D, Brockamnn WP, Junker A, Schmidt R, Hübener KH (1990) Results of fast neutron therapy of adenoidcystic carcinomas of the head and neck at the neutron facility Hamburg-Eppendorf. Strahlenther Onkol 166 (1): 107–110
Kurup PD, Hendrickson F, Cohen L (1982) Radiation therapy utilizing fast neutrons for head and neck cancer-the Fermilab experience. Int J Radiat Oncol Biol Phys 8 Suppl 1: 103–104
Laramore GE (1987) Fast neutron radiotherapy for inoperable salivary gland tumors: is it the treatment of choice? Int J Radiat Oncol Biol Phys 13: 1421–1423
Medical Research Council Neutron Therapy Working Group (1986) A comparative review of the Hammersmith (1971–75) and Edinburgh (1977–82) neutron therapy trials of certain cancers of the oral cavity, oropharynx, larynx and hypopharynx. Br J Radiol 59: 429–440
MacDougall RH, Orr JA, Kerr GR, Duncan W (1990) Fast neutron treatment for sqaumous cell carcinoma of the head and neck: final report of Edinburgh randomised trial. Br Med J 301: 1241–1242
Maor MH, Schoenfeld DA, Hendrickson FR, Davis LW, Laramore GE, Thomas FJ, Pajak TF (1986). Evaluation of a neutron boost in head and neck cancer. Am J Clin Oncol 9: 61–661
Mardynsky YS, Sysoyer AS, Andreyev VG, Gulidov IA (1991) Preliminary rsults of clinical application of reactor fast neutrons in radiation and combined therapy of patients with laryngeal carcinoma. Strahlenther Oncol 167: 169–171
Sas-Korczynska B, Skolyszewski J (1996) Acute and late reactions of fast neutron therapy in patients with head and neck cancer-the Krakow experience. In: Current status and future directions in particle therapy. Proceedings of the XXIV PTCOG Meeting 24–26 April
Saroja KR, Hendrickson FR, Cohen L, Mansell J, Lennox A (1988) Re-irradiation of locally recurrent tumors with fast neutrons. Int J Radiat Oncol Biol Phys 15: 115–121
Skolyszewski J, Korzeniowski S (1988) Re-irradiation of recurrent head and neck cancer with fast neutrons. Br J Radiol 61: 527–528
Skolyszewski J, Reinfuss M (1985) Results of fast neutron therapy for advanced carcinomas of the oral cavity and oropharynx. Radiobiol Radiother 26: 85–89
Skolyszewski J, Korzeniowski S, Huczkowski J (1988) Results of fast neutron therapy in advanced head and neck cancer. Br J Radiol 61: 301–304
Stannard C, Vernimmen F, Jones D, Wilson J, van Wijk L, Brennan S, Schreuder N, Symons J, Levin V, Mills E, Alberts A, Werner D, Smit B, Schmitt G (1995) Neutron therapy program at the national acelerator centre, South Africa-preliminary results: Radiat Oncol Invest 2: 245–255
Tsunemoto H, Arai T, Morita S, Ishikava T, Aoki Y, Takada N, Kamata S (1982) Japanese experience with clinical trials of fast neutrons. Int J Radiat Oncol Biol Phys 8: 2169–2172
Tsunemoto H, Morita S, Satoh S, Iino Y, Yoo Y (1989) Present status of fast neutron therapy in Asian countries. Strahlenther Onkol 165: 330–336
Wambersie A (1990) Fast neutron therapy at the end of 1988-a survey of the clinical data. Strahlenther Onkol 166: 52–60
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1998 Springer-Verlag Berlin · Heidelberg
About this paper
Cite this paper
Auberger, T., Reuschel, W. (1998). The Role of Fast Neutrons in the Treatment of Squamous Cell Carcinomas of the Head and Neck: The European Experience. In: Engenhart-Cabillic, R., Wambersie, A. (eds) Fast Neutrons and High-LET Particles in Cancer Therapy. Recent Results in Cancer Research, vol 150. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78774-4_8
Download citation
DOI: https://doi.org/10.1007/978-3-642-78774-4_8
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-78776-8
Online ISBN: 978-3-642-78774-4
eBook Packages: Springer Book Archive