[Fast neutrons 6.3 MeV in the combined treatment of patients with local recurrence of breast cancer].

The article is devoted to the problem of treatment of patients with locally advanced breast cancer recurrences as well as a study of neutron therapy influence on normal tissues and various critical organs. The use of fast neutrons of 6.3 MeV in these patients is often the only treatment option. A 6-year survival rate of patients without repeated signs of recurrent breast cancer after neutron and neutron-photon therapy is 92.2 ± 5.7%.

[The use of fast neutrons in treatment of malignant tumors of the head and neck].

The article presents issues of the application of neutron therapy in the combined and radiation therapy for head and neck tumors. There were developed methods of neutron and neutron-photon therapy in pre- and postoperative periods as well as in stand-alone option in unresectable tumors. The data obtained clearly demonstrate the superiority of new ways over standard methods of treatment. Neutron therapy is satisfactorily tolerated and allows improving the results of combined and radiation therapy patients with malignant tumors of the head and neck.

[Ozone therapy for radiation reactions and skin lesions after neutron therapy in patients with malignant tumors].

The article discusses the problem of radiation complications from normal tissues in patients after therapy with fast neutrons of 6.3 MeV. The methods of treatment using ozone technologies in patients with radiation reactions and skin lesions on the areas of irradiation after neutron and neutron-photon therapy have been worked out. Ozone therapy showed its harmlessness and increased efficiency of complex treatment of these patients.

[Radiation-induced reactions in breast cancer patients after breast-conserving surgery with intraoperative and external beam radiotherapy].

The present study is aimed to evaluate the frequency and severity of radiation-induced reactions in patients with stage T1-2N0-1M0 breast cancer, who received intraopeartive radiation therapy (IORT) in combination with external beam radiotherapy (EBRT). A small-size betatron producing 6 MeV electron beam was used for IORT. External beam radiotherapy was performed using Rokus and Theratron machines. Radiotherapy treatment was planned using a specially devised method to ensure acceptable levels of severity and frequency of radiation reactions. The patients were divided into 3 groups: the study (40 patients), control (88) and comparison (50) ones. Radiation-induced skin reactions in the study group ranged from erythema to moist desquamation and edema. Magnetic laser therapy was used to treat radiation-induced injuries. The applied method of estimating the total dose of IORT and EBRT was shown to provide the acceptable levels of severity and frequency of radiation reactions.

[The results of combined treatment for stage III lung cancer including the use of intraoperative radiotherapy].

The results of combined treatment including intraoperative radiation therapy (IORT) were assessed in 147 patients with stage III non-small cell lung cancer. Preoperative chemotherapy with paclitaxel/carboplatin followed by surgery with 15 Gy IORT and additional administration of radiosensitization with cisplatin resulted in a significant increase in the 5-year survival rate compared to surgery alone (39.2% and 47.9%, versus 29.2%, p<0.05).

[Effect of combined modality treatment with intraoperative radiotherapy on the morphofunctional state of the myocardium in patients with stage-III lung cancer].

Epy influence of combined treatment including neoadjuvant chemotherapy, radical surgery and intraoperative radiotherapy with a single dose of 15 Gr or 10 Gr has been studied in conditions of radiosensibilization on morphological and functional status of myocardium in non-small lung cancer patients at stage III with by means of ECG-synchronized single-photon emission computed tomography of myocardium with 99mTc MIBI. It was shown that this kind of treatment does not worsen functional status of myocardium, besides the perfusion level of myocardium correlated with initial concomitant cardiovascular pathology and extent of surgical treatment.

[The clinical course of thyroid cancer following its combined treatment with the use of fast-neutron therapy in the patients at the high risk of relapses].

A few patients presenting with thyroid cancer characterized by the high risk of relapses are reported. Their combined treatment included therapy using fast-neuron with the energy of 6.3 MeV. The immediate and late results of the treatment of the reported cases are evaluated. The experience gained during the study gives evidence of the fairly good tolerability of the described radiotherapeutic modality producing neither acute radiation reactions nor lesions in the irradiated tissues and organs. Moreover, the treatment is described as a highly effective one.

[Experience with neutron teletherapy of malignant tumors]. / Opyt distantsionnoi neitronnoi terapii zlokachestvennykh opukholei.

A medico-biological complex for fast neutron therapy of cancer and research in physics and radiobiology was developed at the Siberian Branch of the Center within the framework of Cyclotron Department of Research Institute of Nuclear Physics (Polytechnical Institute, Tomsk). Certain problems of forming a fast neutron beam from the Y-120 type cyclotron are discussed. Baseline data of dosimetric and radiobiologic studies are presented. The first experience of Soviet researchers with fast neutron treatment of head and neck cancer is described. Favorable preliminary results suggest further clinical application of the said procedure.

[3 years' experience of radiation therapy with fast neutrons on the V-120 cyclotron]. / Trekhletnii opyt luchevoi terapii bystrymi netronami na tsiklotrone V-120.

The paper discusses the results of treatment of 128 patients with head and neck cancer in whom fast neutrons (Y-120; approximately 6.2 MeV) were used as a single procedure or in combination with surgery. Tumors of different histomorphologic structure displayed unequal sensitivity to fast neutrons. Mean disease-free survival in patients with complete regression of tumor was 24 months following neutron therapy alone, 18.5 months after combined neutron-photon treatment and 5.5 months only in controls. Relapse rates were 20 and 15% in patients with pre- and postoperative neutron treatment, respectively, as compared to 52% in controls.

[A case of successful treatment of resistant tumors with fast neutrons]. / Sluchai uspeshnogo lecheniia bystrymi neitronami rezistentnykh opukholei.

The authors report two cases of resistant to standard treatment tumors cured by fast neutrons. The recurrence-free period after the treatment with 6.0 MeV neutrons lasted 5 and 2 years for follicular thyroid cancer and breast cancer metastases, respectively. To avoid acute radiation reaction of the laryngeal mucosa copper laser radiation was used.

Tomsk Polytechnic University cyclotron as a source for neutron based cancer treatment.

In this paper we present our cyclotron based neutron source with average energy 6.3 MeV generated during the 13.6 MeV deuterons interactions with beryllium target, neutron field dosimetry, and dosimetry of attendant gamma fields. We also present application of our neutron source for cancer treatment.

Cytogenetic effects of neutron therapy in patients with parotid gland tumors and relapse of breast cancer.

AIM: To assess the frequency and spectrum of chromosome aberrations and micronuclei in peripheral blood lymphocytes of patients with parotid salivary gland tumors and relapse of breast cancer during the course of neutron therapy. MATERIALS AND METHODS: Samples of peripheral blood were obtained from 9 patients with parotid salivary gland tumors (T3N0-3M0) and 8 patients with relapse of breast cancer before, after first fraction and at the end of neutron therapy. The treatment course specified 5.5-8.4 Gy (equivalent to 23-44 Gy of photon irradiation) with 1.3-2.2 Gy per fraction for patients with parotid salivary gland tumors and 4,8-8.0 Gy (equivalent to 30-40 Gy of photon irradiation) with 1.6 Gy per fraction for patients with relapse of breast cancer. Control group established for conventional cytogenetic analysis consisted of 15 healthy persons. Assessment of chromosome aberrations frequency was performed on routinely stained metaphase plates. Lymphocytes from the same patients were analyzed by micronucleus test in combination with fluorescent in situ hybridization (FISH) using pancentromeric DNA probe. RESULTS: Level of chromosome aberrations and micronuclei significantly increased in lymphocytes of patients from both groups during neutron therapy (P < 0.05). This increase was mainly due to chromosome-type aberrations and centromere-negative micronuclei. The prevalent types of aberrations are in agreement with theoretical mechanisms of neutron effects on cells. CONCLUSION: Cytogenetic effects of fast neutron therapy in lymphocytes of patients with parotid salivary gland tumors and relapse of breast cancer were observed. A positive dynamics of radiation-induced chromosomal damages formation during the course was denoted in lymphocytes of cancer patients in both groups.

[Quantitative evaluation of tumor radiation reactions by their radiobiological parameters]. / Kolichestvennaia otsenka luchevykh reaktsii opukholei s uchetom ikh radiobiologicheskikh parametrov.

An effect of the radiosensitivity of tumors on the degree of their regression in fractionated irradiation was studied theoretically. It has been shown that the efficacy of tumor regression depends significantly on the radiobiological parameters of tumors.

[The postoperative period in malignant tumors of the paranasal sinuses following preoperative and radical regimens of neutron therapy]. / Posleoperatsionnyi period pri zlokachestvennykh opukholiakh pridatochnykh pazukh nosa posle predoperatsionnogo i radikal'nogo kursov neitronnoi terapii.

Surgical intervention was performed in 16 patients with advanced tumors of the accessory sinuses and nose receiving neutron teletherapy. The 1st group (10 persons) was treated by combined therapy including preoperative irradiation with fast neutrons: 2 fractions a week at a dose of 1.2-1.4 Gy, total focal dose of 10 Gy corresponding to an equivalent dose of 40 Gy. Surgical intervention was performed in 10-15 days. In the 1st group during the post-operative period there were no complications, the period of wound healing was not increased as compared to that in the use of routine methods of combined therapy of tumors of the above site. In the 2nd group (6 persons) surgical intervention was performed 2-3 mos. after a radical course of combined neutron-photon therapy. The frequency of postoperative complications was 67%. The period of post-operative wound healing considerably increased.

[Radiation-induced changes in normal tissues during neutron-photon therapy of recurrent cancer of the root of the tongue]. / Luchevye izmeneniia normal'nykh tkanei pri neitronno-fotonnoi terapii retsidiva raka kornia iazyka.

The paper is concerned with a case of a 2-year follow-up of a patient with recurrent cancer of the root of the tongue treated with fast neutrons on the Y-120 cyclotron. Medical history included a preoperative course of photon therapy at a dose of 40 Gy and operation. The total focal dose of fast neutrons of a repeated irradiation course was 11.2 Gy, that of photons--14 Gy corresponding to a total photon equivalent dose of 50 Gy. The authors provided the evidence of late radiation changes of the skin, temporomandibular articulation, pharynx, and the upper esophagus, and analyzed the causes of development of radiation complications.

[The reoxygenation of superficial tumors in fast-neutron therapy]. / Reoksigenatsiia poverkhnostno-raspolozhennykh opukholei pri terapii bystrymi neitronami.

The paper is concerned with the data on reoxygenation of superficial tumors in 38 patients exposed to densely and scarcely ionizing radiation. Tumor reoxygenation curves are presented. A tumor regression rate and reoxygenation of a tumor with respect to its original size showed correlation during fast-neutron therapy at 6.3 MeV.

[Long-term radiation injuries following neutron therapy]. / Pozdnie luchevye povrezhdeniia posle neitronnoi terapii.

The paper is concerned with the data on late radiation injuries of normal tissues and critical organs in a group of 35 patients after fast neutron therapy in a period of 12 mos.-3.5 yrs. The value of radiation exposure of critical organs and tissues was considered for patients with head and neck tumors in relation to methods of fast neutron therapy and photon radiation with 60Co after a radical program.

[Preparation of patients with head and neck tumors for neutron teletherapy]. / Podgotovka bol'nykh s opukholiami golovy i shei distantsionnoi neitronnoi terapii.

The authors discuss some problems of preradiation preparation of patients with head and neck tumors for neutron teletherapy on the U-120 cyclotron of the Tomsk Polytechnical Institute in the Siberian Branch of the All-Union Cancer Research Center, AMS USSR. Some methods of the manufacture and employment technique of the fixing and forming devices for the optimization of neutron therapy are described.