Budach V
Universitäts-Strahlenklinik, Gesamthochschule Essen.
Strahlenther Onkol. 1991 Dec;167(12):677-92.
The contribution of fast neutrons to local tumour control has been investigated worldwide since the mid-60's in more than 20 institutions. The high expectations anticipated from the promising results of experimental studies could not be adequately realized in the clinic. The late normal tissue damage was unacceptable due to poor depth dose characteristics and further technical limitations of the first generation low-energy machines. Even with sophisticated therapy planning systems and high-energy cyclotrons as well as comparable late normal tissue damage as witnessed after photons, only a few tumour entities have responded superiorly to fast neutrons. These particularly include macroscopic tumours of the salivary glands, prostate and, potentially, soft and osseous tissues. The role of fast neutrons for head and neck cancer has not yet been definitely proved. For bladder-, cervical- and rectal carcinomas, non-small cell lung-, pancreatic- and breast cancers as well as malignant gliomas, no therapeutic benefit as compared with photons was observed in the case of macroscopic residual or inoperable recurrent tumours.
自60年代中期以来，全球20多家机构对快中子在局部肿瘤控制方面的作用进行了研究。实验研究取得了令人鼓舞的结果，人们寄予厚望，但在临床中却未能充分实现。由于第一代低能量机器深度剂量特性不佳以及其他技术限制，晚期正常组织损伤令人难以接受。即便有了先进的治疗计划系统和高能回旋加速器，且晚期正常组织损伤与光子治疗后相当，但只有少数肿瘤实体对快中子反应更佳。这些肿瘤特别包括唾液腺、前列腺的宏观肿瘤，以及可能的软组织和骨组织肿瘤。快中子对头颈部癌的作用尚未得到明确证实。对于膀胱癌、宫颈癌和直肠癌、非小细胞肺癌、胰腺癌和乳腺癌以及恶性胶质瘤，在宏观残留或无法手术的复发性肿瘤病例中，与光子治疗相比未观察到治疗益处。
