Fast neutron irradiation in advanced pre-irradiated head and neck tumors

Aims and background: Radiotherapy with fast neutrons offers radiobiological advantages in the treatment of hypoxic and slowly proliferating tumors. Tumors recurring in pre-irradiated areas of the head and neck usually exhibit a low radiation sensitivity that seems to promise little success for a repeated irradiation with photons. In such a situation, radiotherapy with fast neutrons may offer an alternative treatment option. To evaluate the question, the Muenster patients were retrospectively analyzed. Methods: During the period July 1986 to January 1994, 26 patients with local-regional recurrences of pre-irradiated head and neck tumors were treated with fast neutrons at our department. Results: Median survival calculated by the Kaplan-Meier method was 7.4 months. The 1-year survival probability was 29.3% and the 5-year survival probability 5.9%. The objective tumor remission (complete + partial) was 50%. A subjective improvement of symptoms was reported by 42.3% of ail patients. Conclusions: Despite relatively unfavorable survival rates produced by the therapy, good remission rates and thereby a good palliative effect can be attained with a short treatment time and tolerable side effects.