Schmitt G, Wambersie A
Klinik für Strahlentherapie, Universität Düsseldorf, F.R.G.
Radiother Oncol. 1990 Jan;17(1):47-56. doi: 10.1016/0167-8140(90)90048-2.
The clinical results reported from the different neutron therapy centres are reviewed. Fast neutrons were shown to be useful in the treatment of locally extended inoperable salivary gland tumours (average local control rates 67% for neutrons compared to 28% for photons). For paranasal sinuses and some tumours of the head and neck area, especially extended tumours with large fixed lymph nodes, neutrons could also be of interest. By contrast, the results obtained for brain tumours were, in general, disappointing. Neutrons were shown to be beneficial in the treatment of well differentiated soft tissue sarcomas, as well as to bone- and chondrosarcomas. For locally extended prostatic adenocarcinoma, a RTOG randomized trial gave local control rates of 77% for mixed schedule compared to 31% for photons. Neutrons could be useful also for palliative treatment of melanomas. Further studies are needed in order to evaluate the benefit of fast neutrons for other localizations such as uterine cervix, bladder and rectum. It can be concluded that fast neutrons could be of interest for about 10% of the radiotherapy patients, but it is likely that the new high-energy hospital-based cyclotrons will further extend the indications of neutron therapy. However, patient selection remains one of the main problems and there is a need for development of individual predictive tests.
本文综述了不同中子治疗中心报告的临床结果。结果表明，快中子在治疗局部广泛、无法手术切除的唾液腺肿瘤方面具有显著疗效（中子治疗的局部控制率平均为67%，而光子治疗为28%）。对于鼻窦及头颈部的某些肿瘤，特别是伴有大的固定淋巴结的广泛肿瘤，中子治疗也可能具有一定价值。相比之下，脑肿瘤的治疗结果总体上令人失望。快中子在治疗高分化软组织肉瘤、骨肉瘤和软骨肉瘤方面显示出优势。对于局部广泛的前列腺腺癌，一项美国放射肿瘤学组（RTOG）的随机试验表明，混合治疗方案的局部控制率为77%，而光子治疗为31%。快中子在黑色素瘤的姑息治疗中也可能发挥作用。为评估快中子在其他部位（如子宫颈、膀胱和直肠）的治疗效果，还需进一步开展研究。可以得出结论，快中子可能适用于约10%的放疗患者，但新型高能医院用回旋加速器可能会进一步扩大中子治疗的适应症。然而，患者选择仍是主要问题之一，且需要开发个体化的预测检测方法。
