Fast Neutron Irradiation in Advanced Pre-Irradiated Head and Neck Tumors

Abstract

Aims and background Radiotherapy with fast neutrons offers radiobiological advantages in the treatment of hypoxic and slowly proliferating tumors. Tumors recurring in pre-irradiated areas of the head and neck usually exhibit a low radiation sensitivity that seems to promise little success for a repeated irradiation with photons. In such a situation, radiotherapy with fast neutrons may offer an alternative treatment option. To evaluate the question, the Muenster patients were retrospectively analyzed. Methods During the period July 1986 to January 1994, 26 patients with local-regional recurrences of pre-irradiated head and neck tumors were treated with fast neutrons at our department. Results Median survival calculated by the Kaplan-Meier method was 7.4 months. The 1-year survival probability was 29.3% and the 2-year survival probability 5.9%. The objective tumor remission (complete + partial) was 50%. A subjective improvement of symptoms was reported by 42.3% of all patients. Conclusions Despite relatively unfavorable survival rates produced by the therapy, good remission rates and thereby a good palliative effect can be attained with a short treatment time and tolerable side effects.