Californium-252 neutron brachytherapy combined with external pelvic radiotherapy plus concurrent chemotherapy for cervical cancer: a retrospective clinical study.

Abstract

BACKGROUND:

Cervical cancer is the sixth most common cancer in Chinese women. A standard treatment modality for cervical cancer is the combination of surgery, chemotherapy, external-beam radiotherapy and intracavitary brachytherapy. The aim of this study was to retrospectively assess the long-term treatment outcomes of patients with cervical cancer who were treated with californium-252 neutron brachytherapy combined with external-beam radiotherapy plus concurrent chemotherapy.

METHODS:

We retrospectively analyzed the medical records of 150 patients with primary stages IB-IVB cervical cancer who received neutron brachytherapy combined with external-beam radiotherapy concurrently with cisplatin chemotherapy. All patients were followed up. Using an actuarial analysis, patient outcomes and treatment-related adverse effects were evaluated and compared.

RESULTS:

The median overall survival (OS) was 33.2 months. The 3-year progression-free survival rates for patients with stages I-II, III, and IV diseases were 81.0% (68/84), 65.0% (39/60), and 0% (0/6), respectively; the 3-year OS rates were 90.5% (76/84), 85.0% (51/60), and 16.7% (1/6), respectively. Vaginal bleeding was controlled within the median time of 4.0 days. One month after treatment, 97.3% of patients achieved short-term local control. The local recurrence rates for patients with stages I-II, III, and IV disease were 4.8% (4/84), 11.7% (7/60), and 33.3% (2/6), respectively, and the occurrence rates of distant metastasis were 16.7% (14/84), 25.0% (15/60), and 100.0% (6/6), respectively. Cancer stage, tumor size, and lymph node metastasis were identified as prognostic risk factors, but only lymph node metastasis was found to be an independent prognostic factor. The most common adverse effects during treatment were grades 1 and 2 irradiation-related proctitis and radiocystitis.

CONCLUSION:

For patients with cervical cancer, neutron brachytherapy combined with external-beam radiotherapy plus concurrent chemotherapy produces a rapid response and greatly improves local control and long-term survival rates with tolerable adverse effects.

• Authors: Shen Qian, Ling Ye, Yun-Hong Tian, Li-Gen Wang, Zuo-Ping Huang, Feng Li, Bing Hou, Ni Song, Juan Chen, Ying Liu, Xiao Liu, Tao Zhou
• Journal: Chinese journal of cancer (Chin J Cancer) Vol. 36 Issue 1 Pg. 24 (Feb 28 2017) ISSN: 1944-446X [Electronic] England
• PMID: 28245859 (Publication Type: Journal Article)

Chemical References

• Antineoplastic Agents
• Californium
• Cisplatin

Topics

• Adult
• Aged
• Antineoplastic Agents (therapeutic use)
• Brachytherapy
• Californium (therapeutic use)
• Chemoradiotherapy
• Cisplatin (therapeutic use)
• Disease-Free Survival
• Female
• Humans
• Kaplan-Meier Estimate
• Middle Aged
• Neutrons (therapeutic use)
• Pelvis
• Uterine Cervical Neoplasms (radiotherapy, therapy)