Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb 28;36(1):24.
doi: 10.1186/s40880-017-0191-x.

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

Shen Qian  1 , Ling Ye  2 , Yun-Hong Tian  3 , Li-Gen Wang  4 , Zuo-Ping Huang  4 , Feng Li  4 , Bing Hou  4 , Ni Song  4 , Juan Chen  4 , Ying Liu  4 , Xiao Liu  4 , Tao Zhou  5
Affiliations

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

Shen Qian et al. Chin J Cancer. .

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.

Keywords: Californium-252; Cervical cancer; External-beam radiotherapy; Neutron brachytherapy.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Schematic representation of californium-252 (252Cf) neutron brachytherapy (NBT). Contrast media was injected into a Foley catheter. Then, three passive cavity applicators were inserted into the uterine cavity and bilateral fornix; the applicator that delivers 252Cf was inserted and fixed to the vagina and uterine cavity. Finally, orthogonal radiographs of the pelvic cavity were acquired from the antero-posterior (a) and lateral (b) directions. The yellow arrows indicate the cavity applicators
Fig. 2
Fig. 2
Kaplan-Meier curves of 3-year progression-free survival and 3-year overall survival for 150 patients with cervical cancer who were treated with 252Cf NBT combined with external-beam radiotherapy (EBRT) plus concurrent chemotherapy. a Progression-free survival; b overall survival
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Chen W, Zheng R, Zeng H, Zhang S. The updated incidences and mortalities of major cancers in China, 2011. Chin J Cancer. 2015;34(11):502–507. - PMC - PubMed
    1. Viswanathan AN, Thomadsen B. American Brachytherapy Society Cervical Cancer Recommendations Committee; American Brachytherapy Society. American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix. Part I: general principles. Brachytherapy. 2012;11(1):33–46. doi: 10.1016/j.brachy.2011.07.003. - DOI - PubMed
    1. Monk BJ, Tewari KS, Koh WJ. Multimodality therapy for locally advanced cervical carcinoma: state of the art and future directions. J Clin Oncol. 2007;25(20):2952–2965. doi: 10.1200/JCO.2007.10.8324. - DOI - PubMed
    1. Tanderup K, Eifel PJ, Yashar CM, Pötter R, Grigsby PW. Curative radiotherapy for locally advanced cervical cancer: brachytherapy is NOT optional. Int J Radiat Oncol Biol Phys. 2014;88(3):537–539. doi: 10.1016/j.ijrobp.2013.11.011. - DOI - PubMed
    1. Quinn MA, Benedet JL, Odicino F, Maisonneuve P, Beller U, Creasman WT, et al. Carcinoma of the cervix uteri. FIGO 26th Annual Report on the results of treatment in gynecological Cancer. Int J Gynaecol Obstet. 2006;95(Suppl 1):S43–S103. doi: 10.1016/S0020-7292(06)60030-1. - DOI - PubMed