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Title: Neutron therapy for salivary and thyroid gland cancer

Abstract

The purpose of this study was to analyze the results of the combined modality treatment and radiation therapy using 6.3 MeV fast neutrons for salivary gland cancer and prognostically unfavorable thyroid gland cancer. The study group comprised 127 patients with salivary gland cancer and 46 patients with thyroid gland cancer, who received neutron therapy alone and in combination with surgery. The results obtained demonstrated that the combined modality treatment including fast neutron therapy led to encouraging local control in patients with salivary and thyroid gland cancers.

Authors:
;  [1];  [2]; ; ;  [1]
  1. Tomsk Cancer Research Institute, Kooperativny Street 5, Tomsk, 634050 (Russian Federation)
  2. (Russian Federation)
Publication Date:
OSTI Identifier:
22608277
Resource Type:
Journal Article
Resource Relation:
Journal Name: AIP Conference Proceedings; Journal Volume: 1760; Journal Issue: 1; Conference: PC'16: International conference on physics of cancer: Interdisciplinary problems and clinical applications 2016, Tomsk (Russian Federation), 22-25 Mar 2016; Other Information: (c) 2016 Author(s); Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; FAST NEUTRONS; MEV RANGE 01-10; NEOPLASMS; NEUTRON BEAMS; NEUTRON THERAPY; PATIENTS; SALIVARY GLANDS; SURGERY; THYROID

Citation Formats

Gribova, O. V., E-mail: gribova79@mail.ru, Choynzonov, E. L., E-mail: nii@oncology.tomsk.ru, National Research Tomsk Polytechnic University, Lenina Avenue 30, Tomsk, 634050, Musabaeva, L. I., E-mail: musabaevaLI@oncology.tomsk.ru, Lisin, V. A., E-mail: Lisin@oncology.tomsk.ru, and Novikov, V. A., E-mail: dr.vanovikov@gmail.com. Neutron therapy for salivary and thyroid gland cancer. United States: N. p., 2016. Web. doi:10.1063/1.4960240.
Gribova, O. V., E-mail: gribova79@mail.ru, Choynzonov, E. L., E-mail: nii@oncology.tomsk.ru, National Research Tomsk Polytechnic University, Lenina Avenue 30, Tomsk, 634050, Musabaeva, L. I., E-mail: musabaevaLI@oncology.tomsk.ru, Lisin, V. A., E-mail: Lisin@oncology.tomsk.ru, & Novikov, V. A., E-mail: dr.vanovikov@gmail.com. Neutron therapy for salivary and thyroid gland cancer. United States. doi:10.1063/1.4960240.
Gribova, O. V., E-mail: gribova79@mail.ru, Choynzonov, E. L., E-mail: nii@oncology.tomsk.ru, National Research Tomsk Polytechnic University, Lenina Avenue 30, Tomsk, 634050, Musabaeva, L. I., E-mail: musabaevaLI@oncology.tomsk.ru, Lisin, V. A., E-mail: Lisin@oncology.tomsk.ru, and Novikov, V. A., E-mail: dr.vanovikov@gmail.com. Tue . "Neutron therapy for salivary and thyroid gland cancer". United States. doi:10.1063/1.4960240.
@article{osti_22608277,
title = {Neutron therapy for salivary and thyroid gland cancer},
author = {Gribova, O. V., E-mail: gribova79@mail.ru and Choynzonov, E. L., E-mail: nii@oncology.tomsk.ru and National Research Tomsk Polytechnic University, Lenina Avenue 30, Tomsk, 634050 and Musabaeva, L. I., E-mail: musabaevaLI@oncology.tomsk.ru and Lisin, V. A., E-mail: Lisin@oncology.tomsk.ru and Novikov, V. A., E-mail: dr.vanovikov@gmail.com},
abstractNote = {The purpose of this study was to analyze the results of the combined modality treatment and radiation therapy using 6.3 MeV fast neutrons for salivary gland cancer and prognostically unfavorable thyroid gland cancer. The study group comprised 127 patients with salivary gland cancer and 46 patients with thyroid gland cancer, who received neutron therapy alone and in combination with surgery. The results obtained demonstrated that the combined modality treatment including fast neutron therapy led to encouraging local control in patients with salivary and thyroid gland cancers.},
doi = {10.1063/1.4960240},
journal = {AIP Conference Proceedings},
number = 1,
volume = 1760,
place = {United States},
year = {Tue Aug 02 00:00:00 EDT 2016},
month = {Tue Aug 02 00:00:00 EDT 2016}
}
  • The prevalence of thyroid, parathyroid, and salivary abnormalities was determined in 91 women who received an average of 112 fluoroscopic chest examinations during pneumothorax treatment for tuberculosis more than 40 yr previously and in 72 women treated for tuberculosis by other modalities. Thyroid abnormalities were determined by physical examination, scintiscans, and measurements of serum free T4 index, TSH, and thyroid microsomal antibodies. Thyroid nodules were diagnosed in 7.7% of the exposed and 4.2% of the comparison group (prevalence ratio, 1.8; 90% confidence interval 0.6-5.7). Autoimmune thyroid disease was diagnosed in 15.2% of the exposed and 6.9% of the comparison groupmore » (prevalence ratio, 2.2; 95% confidence interval, 0.8-6.2). No salivary tumors were detected. Two exposed women and 1 comparison woman had primary hyperparathyroidism. Although absorbed dose to the thyroid could not be precisely determined, approximately 60 rads would be expected to yield the observed excess of thyroid nodules. While the prevalence ratios were not significantly increased in the exposed group, the results suggest that susceptibility of the thyroid to nodules from cumulative radiation doses of this magnitude could be increased even when the doses are accumulated over years and that such x-ray exposure of the thyroid gland may predispose the patient to the development of autoimmune disease.« less
  • Nine patients with thyroid cancer were treated with reserpine in an attempt to reduce radiation exposure to the salivary glands from 100-150 mCi doses of I-131 therapy to thyroid remnants or metastases. Three control patients were not treated with reserpine but did receive 100-150 mCi of I-131. Parotid/background ratios of activity after radioablative doses of I-131 in patients not treated with reserpine were significantly higher than the patients treated with reserpine, and this was also true seven days after the radioablative dose. Combined therapy with reserpine, chewing gum, lemon candies, and hydration is suggested for the prevention of sialadenitis andmore » xerostomia due to large doses of radioiodine.« less
  • Purpose: To investigate whether intensity-modulated proton therapy with a reduced spot size (rsIMPT) could further reduce the parotid and submandibular gland dose compared with previously calculated IMPT plans with a larger spot size. In addition, it was investigated whether the obtained dose reductions would theoretically translate into a reduction of normal tissue complication probabilities (NTCPs). Methods: Ten patients with N0 oropharyngeal cancer were included in a comparative treatment planning study. Both IMPT plans delivered simultaneously 70 Gy to the boost planning target volume (PTV) and 54 Gy to the elective nodal PTV. IMPT and rsIMPT used identical three-field beam arrangements.more » In the IMPT plans, the parotid and submandibular salivary glands were spared as much as possible. rsIMPT plans used identical dose-volume objectives for the parotid glands as those used by the IMPT plans, whereas the objectives for the submandibular glands were tightened further. NTCPs were calculated for salivary dysfunction and xerostomia. Results: Target coverage was similar for both IMPT techniques, whereas rsIMPT clearly improved target conformity. The mean doses in the parotid glands and submandibular glands were significantly lower for three-field rsIMPT (14.7 Gy and 46.9 Gy, respectively) than for three-field IMPT (16.8 Gy and 54.6 Gy, respectively). Hence, rsIMPT significantly reduced the NTCP of patient-rated xerostomia and parotid and contralateral submandibular salivary flow dysfunction (27%, 17%, and 43% respectively) compared with IMPT (39%, 20%, and 79%, respectively). In addition, mean dose values in the sublingual glands, the soft palate and oral cavity were also decreased. Obtained dose and NTCP reductions varied per patient. Conclusions: rsIMPT improved sparing of the salivary glands and reduced NTCP for xerostomia and parotid and submandibular salivary dysfunction, while maintaining similar target coverage results. It is expected that rsIMPT improves quality of life during and after radiotherapy treatment.« less
  • Purpose: The present study was conducted to investigate salivary iodine kinetics and dosimetry during repeated courses of radioiodine ({sup 131}I) therapy for differentiated thyroid cancer (DTC). Such data could provide a better understanding of the mechanisms of {sup 131}I induced salivary toxicity and help to develop appropriate methods to reduce this injury. Methods: Seventy-eight consecutive DTC patients (mean age 45 {+-} 17 years, 60%, female) undergoing {sup 131}I therapy for remnant ablation or metastatic tumors were prospectively recruited. Planar quantitative scintigraphy of head-neck images was serially acquired after administration of 2.9-7.4 GBq of {sup 131}I to assess kinetics in themore » salivary glands of patients. Salivary absorbed doses were calculated based on the schema of Medical Internal Radiation Dosimetry. Results: The maximum uptakes in percentage of administered {sup 131}I activity per kilogram of gland tissue (%/kg) were 12.9% {+-} 6.5%/kg (range, 0.4%-37.3%/kg) and 12.3% {+-} 6.2%/kg (range, 0.4%-35.1%/kg) for the parotid and submandibular glands, respectively. Statistically significant correlations of maximum uptake versus cumulative activity (r = -0.74, P < 0.01, for the parotid glands; r = -0.71, P < 0.01, for the submandibular glands) and treatment cycle (P < 0.001, for both gland types) were found. The effective half-lives of {sup 131}I in the parotid and submandibular glands were 9.3 {+-} 3.5 h (range, 1.5-19.8 h) and 8.6 {+-} 3.2 h (range, 0.8-18.0 h), respectively. A statistically significant correlation was observed between effective half-life with cumulative activity (r = 0.37, P < 0.01) and treatment cycle (P = 0.03) only for the parotid glands. The calculated absorbed doses were 0.20 {+-} 0.10 mGy/MBq (range, 0.01-0.92 mGy/MBq) and 0.25 {+-} 0.09 mGy/MBq (range, 0.01-1.52 mGy/MBq) for the parotid and submandibular glands, respectively. The photon contribution to the salivary absorbed dose was minimal in relation to the beta dose contribution. Photon-absorbed dose fractions of total absorbed dose were 4.9% {+-} 1.3% (range, 1.1%-8.7%) and 3.7% {+-} 2.5% (range, 0.8%-7.9%) for the parotid and submandibular glands, respectively. Conclusions: The iodine uptake of salivary glands is continuously reduced during the courses of therapy. The phenomenon of hyper-radiosensitivity may to some extent account for the occurrence of salivary gland hypofunction at very low radiation doses with low dose rates in {sup 131}I therapy. On the other hand, failure to incorporate a nonuniform and preferential uptake by salivary gland ductal cells may result in underestimating the actual dose for the critical tissue. Other methods, including {sup 124}I voxel-based dosimetry, are warranted to further investigate the {sup 131}I-induced salivary gland toxicity.« less