Clinical Report on Californium-252 Neutron Intraluminal Brachytherapy Combined with External Irradia

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OBJECTIVE To observe the curative effects and complications of califium-252 (252Cf) neutron intraluminal brachytherapy (IBT) combined with extal irradiation (El) for treatment of cervical carcinoma.METHODS From December 2000 to December 2004, 128 cases of cervical carcinoma staged into ⅡA~ⅢB according to the Intational Federation of Gynecology and Obstetrics (FIGO) standards were treated with 252Cf neutron IBT using 8~10 Gy per fraction, once a week. The total dose at reference A point was 36~40 Gy in 4~5 fractions. From the second day after 252Cf neutron IBT treatment, the whole pelvic cavity was treated with 60Co γ-ray El, applying 2 Gy per fraction, 4 times per week. After 20~25 Gy of El, the center of the whole pelvic field was blocked with 4 cm of lead in width. The total dose of El was 45~50 Gy.RESULTS The short-term therapeutic effects were CR 95.3% and PR 4.7%. The 3 and 5-year local control rates were 93.5% and 87.9%. The overall 3-year survival rate was 87.5% and for Stages Ⅱ and Ⅲ , 90.9%and 81.5% respectively; the overall 5-year survival rate was 70% and for Stages Ⅱ and Ⅲ, 76.2% and 61% respectively. The rate of radiation complications was 4.7% for radiation cystitis, 7.8% for radiation proctitis, 6.3%for vagina contracture and adhesion and 5.5% for protracted radiation proctitis.CONCLUSION An combination of 252Cf neutron IBT with El for treatment of cervical carcinoma can be well-tolerated by cervical carcinoma patients. The rate of local tumor control is high and radiation complications are few.
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