PubMed · 2493846
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1989-01-21. Radiotherapy's second setback.. https://pubmed.ncbi.nlm.nih.gov/2493846/
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PURPOSE: To demonstrate the consistency of dosimetry data used for four fast neutron generators involved in inter-institutional clinical trials. METHODS AND MATERIALS: Central-axis dosimetry characteristics (field size dependence, percentage depth dose, beam modifier factors) at four institutions were measured by independent physicists from the Radiological Physics Center. These measurements were made in water with a single set of dosimetry equipment using tissue equivalent ionization chambers. Measurements were made with the chamber cavities filled with stationary air and flowing tissue-equivalent gas. All measurements were performed using techniques developed by the Radiological Physics Center for conventional radiotherapy equipment. The results of our measurements were compared to the data used by the institution to determine the consistency of patient doses reported to the Radiation Therapy Oncology Group. RESULTS: The agreement of the Radiological Physics Center and institution data is similar to what is typically found with conventional radiotherapy equipment. CONCLUSIONS: The doses reported by these institutions to the Fast Neutron Working Group of the Radiation Therapy Oncology Group are consistent, within accepted clinical criteria.
Following conflicting results from Hammersmith and Edinburgh, the 62.5 MeV (p-->Be+) Douglas cyclotron was installed at Clatterbridge in order to carry out further studies with fast neutrons. Several features were incorporated into the study design to achieve as unbiased as possible a comparison between 62.5 MeV neutrons and conventional 8 MV x-ray therapy. Interim analysis of 151 patients in the pelvic study in the autumn of 1989 revealed a trend towards a worse survival in the neutron therapy group which soon became significant, leading to study termination in February 1990. The reasons for this diminished survival were unclear; with no significant difference in morbidity. Although the incidence of metastases was initially higher in the neutron patients than the photon patients this difference was not sufficient to explain the survival difference. Considerable morbidity would be expected from photon therapy using the same fractionation as was used in the neutron arm of the trial. If further neutron therapy at this energy is planned consideration should be given to the use of smaller fractions.
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