Abstract
BackgroundCervical 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.MethodsWe 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.ResultsThe 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.ConclusionFor 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.
Highlights
Cervical cancer is the sixth most common cancer in Chinese women
After all 150 patients underwent 252Cf neutron brachytherapy (NBT) combined with externalbeam radiotherapy (EBRT) plus concurrent chemotherapy, 138 (92.0%) reached complete response (CR), 8 (5.3%) reached partial response (PR), 4 (2.7%) had stable disease, and none had progressive disease (PD)
Our retrospective study assessed the long-term treatment outcomes of cervical cancer patients treated with 252Cf NBT combined with EBRT plus concurrent chemotherapy
Summary
A standard treatment modal‐ ity 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 radio‐ therapy plus concurrent chemotherapy. The treatment paradigms in the primary management of cervical cancer are well established, with early lesions being treated surgically or with brachytherapy alone [2] and locally advanced lesions being managed with concurrent chemoradiotherapy [3, 4]. Several studies have shown that adding brachytherapy to the treatment protocol results in prolonged survival for patients with cervical cancer [8,9,10,11]. Studies have shown that nearly each radiotherapy protocol option for so-called radio-resistant tumors is more efficacious than photon brachytherapy; to improve the curability of cervical cancer, new types of radiation should be studied [12]
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