Phase I pilot study on fast neutron teletherapy for advanced carcinomas of the head and neck region: Final report on local control rate and survival

Abstract
A final report is presented on the local control rate and length of survival for 100 patients with advanced squamous cell carcinomas of the head and neck region who received fast neutron teletherapy at the University of Washington during the period 1973 through 1977. Sixty-two patients were treated with neutrons alone and 38 were treated with a combination of neutrons and photons as part of a mixed beam fractionation scheme. The overall initial complete remission rate was 68% for the mixed beam group and 44% for the group treated with neutrons alone. Initial complete remission rates for the two groups of patients are given as a function of T-stage and N-stage and acturarial curves are presented which show the time course of local control and survival for the two treatment groups. For T3 and T4 lesions the initial complete remission rate appears to be greater using the mixed beam form of treatment than using neutrons alone. Treatment to high-dose levels using neutrons alone gave rise to significantly greater morbidity—both acute and late effects—than resulted from the mixed beam form of treatment. Local control rates and survival rates are compared with similar groups of patients treated with neutrons at other institutions.