Fast neutron radiotherapy. The University of Washington experience.
An overview of the University of Washington neutron radiotherapy facility is presented. The utility of the multi-leaf, programmable, variable collimator is emphasized. Due to success in the treatment of salivary gland tumors, such patients comprise an ever increasing portion of the patients being treated. A cooperative randomized clinical trial for the treatment of salivary gland tumors was undertaken comparing fast neutrons against photon/electron radiation. At ten years, there was a statistically significant improvement in local/regional control for the neutron group (56% vs 25%, p = 0.009), but there was no improvement in survival (15% vs 25%, p = n.s.). Distant metastases were the primary reason for the failure of improved local/regional control to impact survival in the neutron group. The University of Washington experience is summarized with special emphasis on the treatment of adenoid cystic carcinomas. Excellent local/regional control can be achieved with neutrons even for large tumors arising in the paranasal sinuses. We conclude that the potential morbidity of a surgical debulking procedure is not warranted in most clinical situations.
Department of Radiation Oncology, University of Washington Medical Center, Seattle 98195.
K J
KJ
Stelzer
G E
GE
Laramore
T W
TW
Griffin
W J
WJ
Koh
M
M
Austin-Seymour
K J
KJ
Russell
T A
TA
Buchholz
D000328:Adult; D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000532:radiotherapy; D005214:Fast Neutrons / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D010255:Paranasal Sinus Neoplasms / Q000532:radiotherapy; D011446:Prospective Studies; D011872:Radiology Department, Hospital / Q000458:organization & administration; D011879:Radiotherapy Dosage; D012468:Salivary Gland Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006113:United Kingdom; D014495:Universities; D014861:Washington