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NEUTRON THERAPY IN CERVICAL CANCER: RESULTS OF A PHASE III RTOG STUDY ( RADIATION ONCOLOGY BIOL. PHYS. VOL.14 )

COHEN, L [FERMI NATIONAL ACCELERATOR LABORATORY, BATAVIA, IL]; CONNER, N [RADIATION THERAPY ONCOLOGY GROUP - PHILADELPHIA, PENNA.]; GARDNER, P [RADIATION THERAPY ONCOLOGY GROUP - PHILADELPHIA, PENNA.]; GILLESPIE, B W [RADIATION THERAPY ONCOLOGY GROUP - PHILADELPHIA, PENNA.]; GRIFFIN, T W; MAOR, M H [UNIVERSITY OF TEXAS]; PETERS, L J [UNIVERSITY OF TEXAS]; THOMAS, F J [CLEVELAND CLINIC, CLEVELAND, OH]; WAMBERSIE, A

HREX; NEUTRON THERAPY STUDY

Location - DOE/NNSA NUCLEAR TESTING ARCHIVE Address - P.O. Box 98521 City - Las Vegas State - NV Zip - 89193-8521 Phone - (702)794-5106 Fax - (702)862-4240 Email - NTA@NV.DOE.GOV

JOURNAL ARTICLE

Never classified

0007

NV0702214

1994 Aug 27

2017 Dec 21

BETWEEN OCTOBER 1976 AND MAY 1984, 156 PATIENTS WITH LOCALLY ADVANCED CERVICAL CANCER WERE ENTERED INTO A PHASE III TRIAL WITH THE PARTICIPATION OF FIVE INSTITUTIONS. PATIENTS WERE RANDOMLY ASSIGNED TO RECEIVE PHOTONS ONLY (50 GY IN 25 FRACTIONS OVER 5 WEEKS PLUS INTRACAVITARY APPLICATIONS OR EXTERNAL-BEAM BOOST) OR MIXED-BEAM RADIOTHERAPY (2 FRACTIONS A WEEK OF NEUTRONS, 3 FRACTIONS A WEEK OF PHOTONS TO A TOTAL RBE ADJUSTED DOSE OF 50 GY OVER 5 WEEKS PLUS INTRACAVITARY APPLICATIONS OR EXTERNAL MIXED-BEAM BOOST). ONLY PATIENTS WITH SQUAMOUS CARCINOMA OF FIGO STAGES IIB, III, OR IVA WITH NEGATIVE PARA-AORTIC NODES ON LYMPHANGIOGRAM WERE ELIGIBLE. TEN PATIENTS WERE EXCLUDED FROM THE ANALYSIS BECAUSE OF INELIGIBILITY OR CANCELLATION. OF THE 146 PATIENTS ANALYZED, 80 WERE TREATED WITH MIXED-BEAM RADIOTHERAPY AND 66 WITH PHOTONS. PATIENTS WERE GROUPED BY STAGE AND INSTITUTION. THE PERCENTAGE OF PATIENTS UNDERGOING INTRACAVITARY APPLICATION WAS 50 PERCENT ON MIXED BEAM AND 75 PERCENT ON PHOTONS ( P < 0.01). TUMOR CLEARANCE WAS 52 PERCENT FOR PHOTONS. MEDIAN SURVIVALS WERE 1.9 YEARS ON MIXED BEAM AND 2.3 YEARS ON PHOTONS. SEVERE COMPLICATIONS OCCURRED IN 19 PERCENT AND 11 PERCENT IN MIXED BEAM AND PHOTONS RESPECTIVELY (P< 0.13). THE INFERIOR OUTCOME WITH NEUTRON THERAPY IN THIS STUDY MAY HAVE RESULTED FROM THE USE OF HORIZONTAL NEUTRON BEAMS OF VARYING ENERGY AND PENETRATION. A NEW RANDOMIZED TRIAL USING HIGH-ENERGY HOSPITAL-BASED CYCLOTRONS WITH GANTRY-MOUNTED BEAM-DELIVERY SYSTEMS HAS RECENTLY BEEN ACTIVATED TO EVALUATE MORE RIGOROUSLY THE ROLE OF FAST-NEUTRON THERAPY FOR ADVANCED CERVICAL CANCER.