Results of fast neutron therapy in advanced head and neck cancer

Eighty-nine patients with advanced head and neck cancer were treated with a fast neutron beam of mean energy 5.6 MeV. The standard tumour dose was 1320 cGyn, gamma in 20 fractions over 4 weeks, but 13 patients with laryngeal cancer received 1200 cGyn, gamma. Complete remission was achieved in 50 patients (56%). Fifteen patients (17%) survived 2 years, 14 of them being symptom-free. Survival correlated with the stage of disease. Encouraging results were obtained for cervical node metastases, oropharynx and salivary gland cancer. In laryngeal and hypopharyngeal cancer, neutron therapy seems to be disadvantageous. The main reason for treatment failure was local recurrence. Two patients died of complications.