Skip to main content
PMC home page
The BMJ logoLink to The BMJ
. 1991 May 4;302(6784):1045–1051. doi: 10.1136/bmj.302.6784.1045

High energy neutron treatment for pelvic cancers: study stopped because of increased mortality.

R D Errington 1, D Ashby 1, S M Gore 1, K R Abrams 1, S Myint 1, D E Bonnett 1, S W Blake 1, T E Saxton 1
PMCID: PMC1669671  PMID: 1903663

Abstract

OBJECTIVE--To compare high energy fast neutron treatment with conventional megavoltage x ray treatment in the management of locally advanced pelvic carcinomas (of the cervix, bladder, prostate, and rectum). DESIGN--Randomised study from February 1986; randomisation to neutron treatment or photon treatment was unstratified and in the ratio of 3 to 1 until January 1988, when randomisation was in the ratio 1 to 1 and stratified by site of tumour. SETTING--Mersey regional radiotherapy centre at Clatterbridge Hospital, Wirral. PATIENTS--151 patients with locally advanced, non-metastatic pelvic cancer (27 cervical, 69 of the bladder, seven prostatic, and 48 of the rectum). INTERVENTION--Randomisation to neutron treatment was stopped in February 1990. MAIN OUTCOME MEASURES--Patient survival and causes of death in relation to the development of metastatic disease and treatment related morbidity. RESULTS--In the first phase of the trial 42 patients were randomised to neutron treatment and 14 to photon treatment, and in the second phase 48 to neutron treatment and 47 to photon treatment. The relative risk of mortality for photons compared with neutrons was 0.66 (95% confidence interval 0.40 to 1.10) after adjustment for site of tumour and other important prognostic factors. Short term and long term complications were similar in both groups. CONCLUSIONS--The trial was stopped because of the increased mortality in patients with cancer of the cervix, bladder, or rectum treated with neutrons.

Full text

PDF
1045

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bonnett D. E., Blake S. W., Shaw J. E., Bewley D. K. The Clatterbridge high-energy neutron therapy facility: specification and performance. Br J Radiol. 1988 Jan;61(721):38–46. doi: 10.1259/0007-1285-61-721-38. [DOI] [PubMed] [Google Scholar]
  2. Duncan W., Arnott S. J., Jack W. J., MacDougall R. H., Quilty P. M., Rodger A., Kerr G. R., Williams J. R. A report of a randomized trial of d(15)+Be neutrons compared with megavoltage X ray therapy of bladder cancer. Int J Radiat Oncol Biol Phys. 1985 Dec;11(12):2043–2049. doi: 10.1016/0360-3016(85)90082-3. [DOI] [PubMed] [Google Scholar]
  3. Duncan W., Arnott S. J., Jack W. J., Orr J. A., Kerr G. R., Williams J. R. Results of two randomised clinical trials of neutron therapy in rectal adenocarcinoma. Radiother Oncol. 1987 Mar;8(3):191–198. doi: 10.1016/s0167-8140(87)80242-6. [DOI] [PubMed] [Google Scholar]
  4. Duncan W., Williams J. R., Kerr G. R., Arnott S. J., Quilty P. M., Rodger A., MacDougall R. H., Jack W. J. An analysis of the radiation related morbidity observed in a randomized trial of neutron therapy for bladder cancer. Int J Radiat Oncol Biol Phys. 1986 Dec;12(12):2085–2092. doi: 10.1016/0360-3016(86)90006-4. [DOI] [PubMed] [Google Scholar]
  5. Elashoff J. D. Surviving proportional hazards. Hepatology. 1983 Nov-Dec;3(6):1031–1035. doi: 10.1002/hep.1840030623. [DOI] [PubMed] [Google Scholar]
  6. Errington R. D., Ashby D., Gore S. M., Abrams K. R., Myint S., Bonnett D. E., Blake S. W., Saxton T. E. High energy neutron treatment for pelvic cancers: study stopped because of increased mortality. BMJ. 1991 May 4;302(6784):1045–1051. doi: 10.1136/bmj.302.6784.1045. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Griffin T., Pajak T., Laramore G., Davis L. Analysis of neutron radiotherapy treatment complications. Bull Cancer. 1986;73(5):582–586. [PubMed] [Google Scholar]
  8. Laramore G. E., Krall J. M., Thomas F. J., Griffin T. W., Maor M. H., Hendrickson F. R. Fast neutron radiotherapy for locally advanced prostate cancer: results of an RTOG randomized study. Int J Radiat Oncol Biol Phys. 1985 Sep;11(9):1621–1627. doi: 10.1016/0360-3016(85)90214-7. [DOI] [PubMed] [Google Scholar]
  9. Laramore G. E. The cyclotron saga. BMJ. 1990 Aug 11;301(6747):344–344. doi: 10.1136/bmj.301.6747.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. MacDougall R. H., Arnott S. J. The cyclotron saga. BMJ. 1990 Jun 30;300(6741):1721–1721. doi: 10.1136/bmj.300.6741.1721. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Maor M. H., Gillespie B. W., Peters L. J., Wambersie A., Griffin T. W., Thomas F. J., Cohen L., Conner N., Gardner P. Neutron therapy in cervical cancer: results of a phase III RTOG Study. Int J Radiat Oncol Biol Phys. 1988 May;14(5):885–891. doi: 10.1016/0360-3016(88)90010-7. [DOI] [PubMed] [Google Scholar]
  12. Wambersie A., Bewley D. K., Lalanne C. M. Prospects for the application of fast neutrons in cancer therapy. Radiobiological bases and survey of the clinical data. Bull Cancer. 1986;73(5):546–561. [PubMed] [Google Scholar]
  13. Zink S., Antoine J., Mahoney F. J. Fast neutron therapy clinical trials in the United States. Am J Clin Oncol. 1989 Aug;12(4):277–282. doi: 10.1097/00000421-198908000-00001. [DOI] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES