Fast neutron therapy in Tomsk: 40-year experience in cancer treatmnet

The purpose of the study was to evaluate the efficacy of neutron therapy (NT) for salivary gland cancer and recurrent breast cancer. Material and Methods. The study included 130 patients with salivary gland cancer and 125 patients with recurrent breast cancer. Fast neutron therapy using U-120 cyclotron was given to the patients of the study group. Patients of the control group received standard radiotherapy (external beam radiotherapy). Results. Among patients with salivary gland cancer, a recurrence rate was significantly lower in patients who received a postoperative course of NT compared to patients of the control group (21.1 vs 45 %, p<0.05). The five-year overall survival rates were 73.8 ± 9.5 % and 43.2 ± 9.4 % in the study group and the control group, respectively (p<0.05). The five-year disease-free survival rates were 65.6 ± 7.5 % and 34.8 ± 9.1 % in the study and control groups, respectively (p<0.05). In patients with recurrent breast cancer, a significant increase in the frequency of complete regression in the study group compared to the control group was observed (91.8 vs 51.3 %, p<0.05). Ten-year survival rates in patients with no evidence of re-recurrence were 77.4 ± 8.7 % and 44.7 ± 8.8 % in the study group and the control group, respectively (p<0.05). Conclusion. The study demonstrated efficacy of fast neutron therapy in patients with salivary gland cancer and recurrent breast cancer. Neutron therapy did not result in serious complications, improved survival of the patients and decreased the recurrence rate compared with standard radiotherapy.

1. Rockhill J.K., Laramore G.E. Neutron Radiotherapy. Clinical Radiation Oncology. 3rd edition. Philadelphia, PA, USA: Elsevier Churchill Livingston, 2011. 1660 p.

2. Brennan J.T., Phillips T.L. Evaluation of past experience with fast neutron teletherapy and its implications for future applications. Eur J Cancer (1965). 1971; 7(2): 219–25. doi: 10.1016/0014-2964(71)90020-x.

3. Catterall M., Bewly D.K. Fast neutrons in the Treatment of Cancer. London: Academic Press, New York, Grune and Stratto, 1979. 394 p.

4. Catterall M. Neutron therapy at Hammersmith Hospital 1970 to 1985. A re-examination of results. Strahlenther Onkol. 1989; 165(4): 298–301.

5. Wagner F.M., Loeper-Kabasakal B., Breitkreutz H. Neutron medical treatment of tumours – a survey of facilities. J. of Instrumentation. 2012; 7: C03041. doi: 10.1088/1748-0221/7/03/C03041.

6. Macomber M.W., Tarabadkar E.S., Mayr N.A., Laramore G.E., Bhatia S., Tseng Y.D., Liao J., Arbuckle T., Nghiem P., Parvathaneni U. Neutron Radiation Therapy for Treatment of Refractory Merkel Cell Carcinoma. Int J Part Ther. 2017; 3(4): 485–91. doi: 10.14338/IJPT-17-00003.1.

7. Musabaeva L.I., Gribova O.V., Choynzonov E.L., Dubskij S.V. Therapy method for inoperable forms of thyroid anaplastic carcinoma. The patent of the Russian Federation No 2344851 RU. 27.01.2009. (in Russian).

8. Dubskiy S.V., Kitsmanjuk Z.D., Musabaeva L.I., Choynzonov E.L. Method for treating the cases of non-differentiated thyroid gland carcinoma. The patent of the Russian Federation No 2194550 RU. 20.12.2002. (in Russian).

9. Musabaeva L.I., Velikaja V.V., Zhogina Zh.A., Lisin V.A. Method for local recurrence prevention in patients suffering locally advanced breast cancer T2-4N1-3M0-1 with unfavourable prognostics. The patent of the Russian Federation No 2444386 RU. 10.03.2012. (in Russian).

10. Chojnzonov E.L., Musabaeva L.I., Lisin V.A. Method for combined treatment malignant neoplasms of periauricular salivary gland. The patent of the Russian Federation No 2206277 RU. 20.06.2003. (in Russian).

11. Musabaeva L.I., Choynzonov E.L. Method of combined treatment of malignant tumors of parotid gland with postoperative neutron therapy. The patent of the Russian Federation No 2145893 RU. 27.02.2000. (in Russian).

12. Musabaeva L.I., Zhogina Zh.A., Velikaja V.V., Lisin V.A. Method for treating local relapses of mammary cancer. The patent of the Russian Federation No 2286818 RU. 10.11.2006. (in Russian).

13. Musabaeva L.I., Lisin V.A., Slonimskaja E.M. Method for neutron-photon therapy of locally spread mammary gland cancer. The patent of the Russian Federation No 2186591 RU. 10.08.2002. (in Russian).

14. Novikov V.A., Musabaeva L.I., Bushmanova T.G., Lisin V.A., Jasenchuk Ju.F. Method of combined treatment of malignant neoplasms of nasal cavity and accessory nasal sinuses. The patent of the Russian Federation No 2153903 RU. 10.08.2000. (in Russian).

15. Choynzonov E.L., Lisin V.A., Gribova O.V., Novikov V.A., Startseva Zh.A. Neutron therapy for malignant neoplasms of the head and neck. Moscow, 2021. 328 p. (in Russian).

16. Choynzonov E.L., Musabaeva L.I., Gribova O.V., Lisin V.A., Avdeenko M.V. Combined treatment and radiotherapy of salivary and thyroid glands cancer using fast neutrons 6.3 MeV. Neutron therapy of cancer. Tomsk, 2008. P. 43–117. (in Russian).

17. Choynzonov E.L., Lisin V.A., Gribova О.V., Velikaya V.V., Startseva Zh.А. Methodological approaches to prevention of radiation-induced skin reactions in neutron-photon therapy for malignant neoplasms. Siberian Journal of Oncology. 2019; 18(2): 44–51. (in Russian). doi: 10.21294/1814-4861-2019-18-2-44-51.

18. Musabaeva L.I., Choynzonov E.L., Gribova O.V., Startseva Zh.A., Velikaya V.V., Lisin V.A. Neutron therapy in the treatment of radioresistant malignant tumors. Siberian Journal of Oncology. 2016; 15(3): 67–71. (in Russian). doi: 10.21294/1814-4861-2016-15-3-67-71.

19. Gribova O.V., Musabaeva L.I., Choinzonov E.L., Novikov V.A., Lisin V.A. The use of fast neutrons in treatment of malignant tumors of the head and neck. Problems in Oncology. 2015; 61(1): 149–53. (in Russian).

20. Novikov V., Musabaeva L., Gribova O. Combined modality treatment including neutron therapy for tumors of the nasal cavity and paranasal sinuses. Adv Mat Res. 2015; 1084: 365–8. doi: 10.4028/www.scientific.net/AMR.1084.365.

21. Gribova O., Musabaeva L., Choynzonov E., Novikov V. Neutron and neutron-photon therapy for head and neck cancer. Adv Mat Res. 2015; 1084: 409–12. doi: 10.4028/www.scientific.net/AMR.1084.409.

22. Musabaeva L.I., Lisin V.A., Startseva Zh.A., Gribova O.V., Velikaya V.V., Melnikov A.A. Neutron therapy on U-120 cyclotron. Medical Radiology and Radiation Safety. 2013; 58(2): 53–61. (in Russian).

23. Velikaya V.V., Startseva Zh.А., Lisin V.А., Goldberg V.E., Popova N.O. Adjuvant neutron therapy in combined modality treatment of patients with primary-metastatic breast cancer. Medical Radiology and Radiation Safety. 2022; 67(5): 64–8. (in Russian). doi 10.33266/1024-6177-2022-67-5-64-68.

24. Velikaya V.V., Startseva Zh.A., Goldberg V.E., Popova N.O., Lisin V.А. Long-Term Treatment Outcomes after Neutron Therapy for Patients with Locally Recurrent Breast Cancer. Journal of Oncology: Diagnostic Radiology and Radiotherapy. 2019; 2(1): 27–32. (in Russian). doi: 10.37174/2587-7593-2019-2-1-27-32.

25. Melnikov A.A., Vasilyev S.A., Smolnikova E.V., Urazova L.N., Musabaeva L.I., Velikaya V.V., Gribova O.V., Ledebev I.N., Choynzonov E.L., Startseva Zh.A. Dynamics chromosomal aberrations and micronuclei in lymphocytes of patients with malignant neoplasms in neutron therapy. Siberian Journal of Oncology. 2012; 4: 52–6. (in Russian).