[Follow-up study of clinical effects of californium-252 neutron intracavitary radiotherapy and external beam radiotherapy in endometrial cancer].
OBJECTIVE
To observe the three year local control rate, overall survival rate, complications and prognostic factors of endometrial cancer treated with (252)Cf neutron intracavitary brachytherapy (ICBT) and external beam radiotherapy (EBRT).


METHODS
Forty endometrial cancer patients staged Ib - IVa by the standard of Federation of International Gynecologic Organization (FIGO), who had not received any treatment were enrolled in this study. Treatment schedules were: (252)Cf ICBT, 10 - 13 Gy(i)/fraction per week, the total dose to point A and point F 35 - 45 Gy(i) and 38 - 50 Gy(i) respectively in 4 fractions. The EBRT was given to the whole pelvic field, with 6 MV or 8 MV X-ray, 2 Gy per fraction, 4 times per week. The total dose was 45 to 50 Gy (the field was blocked 4 cm after 20 - 30 Gy), the total treatment time was 5 - 6 weeks.


RESULTS
The follow-up time was 36 - 96 months, with an average of 42 months. The three year local control and overall survival rate was 88% (35/40) and 75% (30/40) respectively for all patients. Of those patients of stage Ib, they were 93% (14/15) and 87% (13/15), respectively, higher than stage II [80% (12/15), 87% (13/15); P > 0.05], significantly higher than stage III, IV [60% (6/10), 50% (5/10); P < 0.01]. Three year local control and overall survival rate of G(1) grade was 92% (23/25) and 88% (22/25) respectively, significantly higher than G(2) - G(3) grade [80% (12/15), 53% (8/15); P < 0.01]. Three year local control and overall survival rate of adenocarcinoma was 93% (28/30) and 87% (26/30) respectively, significantly higher than squamous adenocarcinoma and papillary adenocarcinoma [70% (7/10), 30% (3/10); P < 0.01]. The grade 2 late radiation cystitis was 2% (1/40), and grade 2, 3 radiation proctitis and sigmoiditis were 10% (4/40).


CONCLUSIONS
Combined (252)Cf ICBT and EBRT may be safe and effective for advanced endometrial cancer. The most important prognostic factors were stage, pathological type and differentiation of endometrial cancer.
Lei
Xin
X
Cancer Center, Third Affiliated Hospital, Third Military Medical University, Chongqing 400042, China. dpleixin@163.com
Shan
Jin-lu
JL
Tang
Cheng
C
Zhao
Ke-wei
KW
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002142:Californium / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D003556:Cystitis / Q000209:etiology; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D004751:Enteritis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
D002142:Californium