Abstract
Results of the first randomized clinical trial to compare the effects of fast neutrons and those of x or gamma rays (photons) in treating patients with advanced tumours of the head and neck are reported. In 37 out of 52 patients treated with neutrons and 16 out of 50 treated with photons the local tumour completely regressed; the tumour later recurred in nine of the 16 photon patients but in none of the 37 neutron patients. The advantages to the neutron-treated patients were seen in tumours of well and poorly differentiated histology and in each site. Complications after treatment did not differ significantly between the groups. Despite these substantial differences in local control of the tumour there were no significant differences in mortality between the series. A detailed study of the effective doses and the response of tumours and normal tissue in each series indicated that the improved results from neutron therapy were due to differences in the biological quality of the beam and not to the rather higher average effective dose in the neutron series. To assess the long-term effects of neutron treatment patients in earlier stages of disease and with smaller tumours should be included in the next phase of the trial.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bewley D. K. Radiation quality and its influence on biological response. Br Med Bull. 1973 Jan;29(1):7–11. doi: 10.1093/oxfordjournals.bmb.a070961. [DOI] [PubMed] [Google Scholar]
- Catterall M. A report on three years' fast neutron therapy from the Medical Research Council's cyclotron at Hammersmith Hospital, London. Cancer. 1974 Jul;34(1):91–95. doi: 10.1002/1097-0142(197407)34:1<91::aid-cncr2820340113>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
- Catterall M. The treatment of advanced cancer by fast neutrons from the Medical Research Council's cyclotron at Hammersmith Hospital, London. Eur J Cancer. 1974 Jun;10(6):343–347. doi: 10.1016/0014-2964(74)90197-2. [DOI] [PubMed] [Google Scholar]
- Catterall M., Vonberg D. D. Treatment of advanced tumours of head and neck with fast neutrons. Br Med J. 1974 Jul 20;3(5924):137–143. doi: 10.1136/bmj.3.5924.137. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Field S. B. The Ellis formulae for x rays and fast neutrons. Br J Radiol. 1972 Apr;45(532):315–317. doi: 10.1259/0007-1285-45-532-315-b. [DOI] [PubMed] [Google Scholar]
- Orton C. G., Ellis F. A simplification in the use of the NSD concept in practical radiotherapy. Br J Radiol. 1973 Jul;46(547):529–537. doi: 10.1259/0007-1285-46-547-529. [DOI] [PubMed] [Google Scholar]
- Peto R., Pike M. C. Conservatism of the approximation sigma (O-E)2-E in the logrank test for survival data or tumor incidence data. Biometrics. 1973 Sep;29(3):579–584. [PubMed] [Google Scholar]