Paving the Road for Modern Particle Therapy – What Can We Learn from the Experience Gained with Fast Neutron Therapy in Munich?

Abstract

While neutron therapy was a highly topical subject in the 70s and 80s, today there are only a few remaining facilities offering fast neutron therapy (FNT). Nevertheless, up to today more than 30,000 patients were treated with neutron therapy. For some indications like salivary gland tumors and malignant melanoma, there is clinical evidence that the addition of FNT leads to superior local control compared to photon treatment alone. FNT was available in Munich from 1985 until 2000 at the Reactor Neutron Therapy (RENT) facility. Patient treatment continued at the new research reactor FRM II in 2007 under improved treatment conditions, and today it can still be offered to selected patients as an individual treatment option. As there is a growing interest in high-linear energy transfer (LET) therapy with new hadron therapy centers emerging around the globe, the clinical data generated by neutron therapy might help to develop biologically driven treatment planning algorithms. Also FNT might experience its resurgence as a combinational partner of modern immunotherapies.

Die Neutronentherapie: Ein Experimentalsystem der Radioonkologie

“…Diem ittels derN eutronentherapie generiertenk linischenD aten kçnntena uchg ewinnbringendf ürd ie Entwicklungv on Algorithmenz ur Behandlungsplanung neuerer LET-Therapieverfahreneingesetztwerden. 81…”

Particle therapy in Europe

“…The advantages are due to the high linear energy transfer (LET) of the charged particles around the Bragg peak: The dense ionization patterns induce clustered DNA lesions that are difficult to repair and trigger different signaling pathways. The effectiveness of high-LET radiation in tumor control was the main rationale for using fast neutrons in radiotherapy (Specht et al, 2015), but in neutron therapy, the LET is high in both normal and tumor tissues, and the depth-dose distribution is similar to photons. On the other hand, in particle therapy the LET can be low in the entrance (plateau) and high in the Bragg peak, and the high-LET radiobiological properties are therefore confined to the tumor region ( Fig.…”

A novel vertebrate system for the examination and direct comparison of the relative biological effectiveness for different radiation qualities and sources

“…In recent years, there has been a marked development of radiation techniques that have contributed to the improvement of cancer treatment outcome (Peeters et al 2010;Allemani et al 2015). Advanced photon delivery techniques with enhanced conformity and the rapidly growing installations of superconducting cyclotron/synchrotron-based particle therapy facilities have made hadron therapy available for an increasing number of cancer patients (Specht et al 2015). Charged particle therapy leads to an increase in dose precision due to the energy deposition characterized by the Bragg peak.…”