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Present status, trends and needs in fast neutron therapy
1Cliniques Universitaires St-Luc, Université Catholique de Louvain (UCL), Brussels, Belgium.
Bulletin Du Cancer. Radiotherapie : Journal De La Societe Francaise Du Cancer : Organe De La Societe Francaise De Radiotherapie Oncologique
|January 1, 1996
Summary
Fast neutron therapy, introduced in the 1970s, remains controversial despite valid radiobiological arguments. Standardizing dose measurement, computation, and reporting, alongside addressing relative biological effectiveness (RBE) challenges, is crucial for objective clinical evaluation.
Area of Science:
- Radiation Oncology
- Medical Physics
- Radiobiology
Background:
- Fast neutron therapy was introduced in the 1970s based on radiobiological principles.
- Despite decades of use, its clinical value and optimal application remain debated.
- Standardization in dosimetry and reporting is needed for objective comparison of results.
Purpose of the Study:
- To address the need for consensus on key issues in fast neutron therapy.
- To propose standardized protocols for dose measurement, computation, and reporting.
- To refine the specification of radiation quality and relative biological effectiveness (RBE).
Main Methods:
- Review and adaptation of International Commission on Radiation Units and Measurements (ICRU) recommendations for neutron dosimetry and dose specification.
- Exploration of microdosimetry as a method to describe radiation quality.
- Proposal of new concepts: "reference RBE" and "clinical RBE" for fast neutron therapy.
Main Results:
- ICRU Report 45 (1989) on Clinical Neutron Dosimetry is now universally applied.
- ICRU photon recommendations (Report 50, 1993) can be adapted for fast neutrons, with attention to tissue composition.
- Microdosimetry offers a method to predict RBE values and improve confidence in experimental data.
Conclusions:
- Standardized protocols for dosimetry and reporting are essential for objective evaluation of fast neutron therapy.
- Addressing the complexities of neutron RBE, particularly its variation with energy, dose, and biological system, is critical.
- Microdosimetry and the proposed "reference RBE" and "clinical RBE" concepts enhance the scientific basis for fast neutron therapy.