Aspects of OER and RBE relevant to neutron therapy

This chapter contains information concerning the mechanisms involved in neutron radiotherapy. Early studies on the attempts of using neutrons in radiotherapy are described. The rationale for fast neutron therapy is discussed as well as the relationships between OER and LET. Tissue responses include: repopulation of surviving cells; repair of sublethal damage; and slow repair. These mechanisms are considered separately. The relationships between RBE and dose per fraction for damage to skin, intestine, esophagus, lungs, hemopoietic tissue, and nerve tissue are discussed. Factors governing the effects of fractionation of dose in neutron radiotherapy are presented. Observations on mammalian cells and tissues show a general reduction in RBE with increasing neutron energy. The benefits of using mixed treatments, part with neutrons and the remainder with photons, are discussed. Problems with this approach include uncertainties of how the combination will effect normal tissue, how it effects slow repair, or its potentially lethal damage. Tumor response, as compared with x rays, to single and multiple doses of radiation is described. Clinical results are given