RBE values of 15 MeV neutrons applied at low dose rates

A tumor/normal tissue advantage for low dose rate neutron brachytherapy

Reports on clinical study of Cf-252 pelvic brachytherapy are reviewed and show that complication frequency is low. Low dose rate (LDR) neutron brachytherapy has been shown to be effective against cervical and advanced pelvic cancers; and produces 5 year cures without a high frequency of normal tissue complications. This is attributed to a high relative biological effectiveness (RBE) for the bulky, hypoxic tumor which along with an oxygen enhancement ratio (OER) advantage and dose-rate independent effects, produces rapid tumor regression and good local tumor control. Adjacent normal tissues which are oxygenated have lower RBE values than that of hypoxic tumors. Cf-252 brachytherapy increases the dose differential, therapeutic gain and the probability of local tumor control, since the high RBE of Cf-252 for hypoxic tumor is much less in normal tissues. Cf-252 radiation concentrated in the tumor, and for this reason, has had much fewer attendant normal tissue complications compared to neutron beam therapy.

RBE values for colo-rectal injury after caesium 137 gamma-ray and neutron irradiation. I. Single doses

Colo-rectal damage in mice has been assessed after caesium gamma irradiation and 3 MeV neutrons given as single doses. Several assays were used, including body weight changes, faecal deformity and lethality. Dose response curves have been constructed for each assay at different times after irradiation, ranging from 10 days to 16 months. The data have been analysed in terms of the time course of expression of damage and the RBE for neutrons. An initial loss of weight at 10-20 days was presumably related to epithelial denudation, but a dose-dependent weight reduction (compared with controls) persisted over the animal's life span. Mice died progressively after localised pelvic gamma irradiation; there was no sharp demarcation between an early and late phase of lethal injury. Death resulted from intestinal stricture or stenosis. The time course for lethality was qualitatively different after neutrons, with little progression of damage between 5 and 11 months. Faecal deformity was detectable as a higher proportion of small pellets when the rectum became constricted by fibrosis. No significant faecal deformity was observed before 6 months after which time dose response curves could be obtained. The RBE for early damage (assessed at 1-3 months) was 2.2-2.7. This fell to 1.7-1.9 for late damage (determined at 10-15 months) over the range of neutron doses of 7.5-12 Gy. The need for sublethal assays allowing for sequential evaluation of radiation damage within the same animal is stressed, as is the need to compare RBE values from early and late endpoints at equivalent neutron doses.

Skin reactions in mouse by fractionated neutron irradiations with the same NSDn

The results of three fractionations of neutron irradiation with the same NSDn were examined for skin reactions in mice. No significant differences were observed between these fractionations given two times a week (15 Gy/12 fractionations/39 days, 14.6 Gy/10 fractionations/32 days and 14.08 Gy/8 fractionations/25 days). The result suggests the value of a high dose per fraction given two times a week.