Long-term results for Stage IIIB cervical cancer patients receiving external beam radiotherapy combined with either HDR Cf-252 or HDR Co-60 intracavitary brachytherapy

作者：Ulinskas K^*; Janulionis E; Valuckas K P; Samerdokiene V; Atkocius V; Rivard M J

来源：Brachytherapy, 2016, 15(3): 353-360.

DOI：10.1016/j.brachy.2016.02.004

• Cervical cancer
• Neutron brachytherapy
• Californium-252

PURPOSE: The aim of this work was to compare the long-term curative effects and complications of patients diagnosed with cervical cancer International Federation of Gynecology and Obstetrics IIIB (n = 430) as treated with Californium-252 (Cf-252) or cobalt-60 (Co-60) intracavitary brachytherapy (ICBT) combined with external beam radiotherapy (EBRT).
METHODS AND MATERIALS: Cervical cancer cases with a history of treatment with Cf-252 or Co-60 ICBT combined with EBRT were selected from the Lithuanian National Cancer Institute database. Complications and second primary malignancies were compared in both patients groups. Estimates of the 5-, 10-, and 15-year overall survival and disease-free survival rates were computed with the Kaplan-Meier method and a Cox proportional hazards model applied using STATA software.
RESULTS: At 5, 10, and 15 years, the overall survival rates were 46.9%, 39.3%, and 34.6% for the Cf-252 group and 35.4%, 26.9%, and 22.5% for the Co-60 group (p = 0.004), respectively. The disease-free survival rates were 42.1%, 35.0%, and 31.0% for the Cf-252 group and 32.0%, 25.1%, and 21.4% for the Co-60 group (p = 0.009), respectively. Histopathologic type of adenocarcinoma increased the risk of death for the Cf-252 group (hazard ratio 3.62). Histopathologic tumor type (hazard ratio 7.48) and recurrence (hazard ratio 2.83) were factors that statistically and significantly influenced the patient prognosis for the Co-60 group.
CONCLUSIONS: Applying Cf-252 ICBT with EBRT was effective for International Federation of Gynecology and Obstetrics In cervical cancer patients. Moreover, long-term followup data demonstrated higher survival rates in patients treated with Cf-252 ICBT than Co-60 ICBT. Complications in patients treated with neutron ICBT were not more frequent or severe than those treated with Co-60 ICBT.

• 出版日期2016-6