Routine operation of the University of Washington fast neutron therapy facility and plans for improvements

The fast neutron therapy facility in Seattle is based on a cyclotron, which produces a 50.5 MeV proton beam. Neutrons are produced in a beryllium target installed in an isocentric gantry equipped with a multi-leaf collimator. The system has been in routine operation for 14 years and over 1800 patients have been treated. Downtime has been minimal, over the past 10 years less than 1.5% of the scheduled daily treatment sessions could not be delivered for equipment related reasons. Fast neutron therapy has been shown to be highly effective for the treatment of salivary gland tumors, sarcomas of bone and soft tissues and for certain prostate cancers. In addition there are situations such as non-small cell lung cancer, where results are promising, but success is limited by normal tissue complications. A relatively small selective increase in the tumor dose might lead to a significant clinical improvement in these situations. The use of a boron neutron capture (BNC) boost, utilizing the moderated slow neutrons naturally present in the tissue during fast neutron therapy, may be beneficial for such patients. Experimental work to adapt the facility for such a modified treatment modality is presently ongoing.