The clinical RBE and microdosimetric characterization of radiation quality in fast neutron therapy

High-LET radiation therapy using fast neutrons is being applied regularly at several centres worldwide and in the future, other types of radiation qualities, such as protons and heavier ions and boron neutron capture therapy (BNCT) are likely to be used. The neutron beams used are of considerably varying energy and thus considerable variations in the relative biological effectiveness (RBE) have been found. At present, no generally accepted method exists for the quantitative specification of these differences in radiation quality for clinical purposes. This is in clear discrepancy with the accuracy requirements in clinical dosimetry. An approach is presented which is based on a single parameter radiation quality characterization determined in combined microdosimetric and radiobiological experiments. It is shown that the method can meet the accuracy requirements of clinical dosimetry and that it is applicable within a concept of formalized procedure of clinical practice and experience ('clinical RBE').