Neutron beam therapy: wave of the future?
Started by fedor
fedor said:
The tough part with fast neutrons is there is no dose build-up and the RBE is variable by tumor type... the skin toxicity is quite notable. On the other hand some of the salivary tumor results are impressive. A prof here worked heavily (program project grant) with neutrons in the 80s and has noted that it seems like neutron therapy is always "almost ready for prime time."
It's hard to get over how useful the Bragg peak of protons seems for dose deposition compared to the LET profile of neutrons. Judging by the fact the Anderson guys are investing $150 million or so in protons, it seems like that is the wave of the future domestically...however, all you need is a proton beam and a beryllium target and you have neutrons....
Neutron Beam therapy is going no where fast. Oak Ridge National Lab has been studying this for awhile. It was popular for awhile, but as the above notes, it's just not that clinically useful (right now) compared with other modalities
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What do you guys think about the use of 'heavy' ions such as carbon or helium. The Bragg-peak is higher compared with photons and it has a very defined endpoint in tissue. I know in japan and europe there are active programs working on this, but are you aware of any US centers ?
nope.fedor said:
BNCT may have a role in some CNS stuff. In terms of techology tomotherapy is an exciting implementation of IMRT. I like Eli Glatstein's comment: If the cure for polio were incumbent upon radiation oncologists, all we'd have now is a better iron lung. Technology is really really important, but we have to not get tunnelvisioned.
Neutron Therapy is goin nowhere. At UCLA we got rid of ours years ago. It's just too unpredictable.
I'd like to get an idea of how many DO's go into Diagonostic Radiology and Radiation Oncology? I got my graduate degree at UCLA in Biomedical Physics and my area of specialty right now is pretty much in radiation oncology. I understand that both are a highly competitive field, and if going to a DO school will seriously hurt my chances, I was thinking of just going the MD route.
What do you guys think?
I'd like to get an idea of how many DO's go into Diagonostic Radiology and Radiation Oncology? I got my graduate degree at UCLA in Biomedical Physics and my area of specialty right now is pretty much in radiation oncology. I understand that both are a highly competitive field, and if going to a DO school will seriously hurt my chances, I was thinking of just going the MD route.
What do you guys think?
kindly stick on topic within a thread and post a question only once; otherwise things get unweidly. Thank you.
stephew said:
I respectfully disagree. I think that we have missed the boat on neutrons. It is true that there is no buildup effect with neutrons, and neutron dosimetry is fundamentally different than protons. With protons the Bragg Peak is important, but neutrons are high LET particles. Protons, although heavy charged particles do not have the same RBE as neutrons. They behave more like low LET particles, in my understanding. (Please correct me if I am wrong as I am not as familiar with protons, right now.)
BNCT (boron neutron capture) works because Boron-10 has a very large neutron interaction cross section. It will cause locally deposited dose. It was a hot topic of research several years ago (including my own). One of the first questions I asked when I began the research was, how to get the boron where we need it? There was no good answer from the project champions. I got my dissertation done from it, won a couple of awards from the research project and BNCT has gone precisely nowhere, I'm sorry to say.
The attraction of BNCT is that it does provide a therapeutic window where there is little to none with neutrons at present. The flaw is that boron concept hinged on the fact that boron was covalently bondable to metabolic precursors which then entered the target cells. The failure was, that the boron went to cells that were metabolizing, and didn't go to the hypoxic cells where it was needed. Photons already work in these cells (OER effect), and we don't get the necessary concentrations of boron in slowly metabolizing or dormant cells needed to open the neutron therapeutic window. I don't expect this to change. I agree we need to do something better with CNS primaries.
I have some ideas in mind....and some of them are not in the tunnel!
As with many other things, the nostalgia of the past may be the wave of the future...but we have a lot of work to do before this happens!
well good luck and more power to you with it. Im more than happy to be wrong.
Why thank you! I'm in the process of putting together a phase I study right now. Watch for coming attractions hopefully at ASTRO next year!stephew said:
Why thank you! I'm in the process of putting together a phase I study right now. Watch for coming attractions!stephew said:
that would be a teriffic achievment. Ill look for the plenary by "3dtp" at astro in a couple of years time...3dtp said:
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