title: Californium-252 neutron brachytherapy combined with external beam radiotherapy for esophageal cancer: long-term treatment results.
abstract: OBJECTIVE
  The aim of this study was to retrospectively observe and analyze the long-term treatment outcomes for a total of 952 esophageal cancer patients who were treated with (252)Cf neutron brachytherapy (NBT) in combination with external beam radiotherapy (EBRT).
  
  
  METHODS
  From November 2001 to March 2012, 952 patients with esophageal cancer underwent NBT in combination with EBRT. The patient numbers distributed over various cancer Stages I, IIA, IIB, III, and IVA were 9, 290, 51, 579, and 23, respectively. The total radiation dose to the reference point via NBT was 8-25 Gy-eq in three to five fractions with one fraction/week. The total dose via EBRT was 40-60 Gy delivered over a period of 5-6 weeks with normal fractionation.
  
  
  RESULTS
  The overall median survival time was 20.3 months. The 1-, 3-, and 5-year survival rates were 67.1%, 36.3%, and 26.6%, respectively. These results compare favorably with the results obtained from conventional high-dose rate in combination with EBRT. Although a majority of the patients (860 or 90.3%) developed Grades 1 and 2 esophagitis during treatment, the symptoms were effectively relieved after the application of antacid and surface anesthesia.
  
  
  CONCLUSIONS
  The clinical data show that NBT in combination with EBRT produced favorable local control and long-term survival rates for patients with esophageal cancer and that the side effects are tolerable. As such, we conclude that this dual-modality method is an effective and safe way for treating esophageal cancer.
authors.affiliation: Department of Radiation Oncology, District Hospital of Changzhi City, Shanxi, People's Republic of China.
authors.forename: Huiming
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, District Hospital of Changzhi City, Shanxi, People's Republic of China.
authors.forename: Qifeng
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, District Hospital of Changzhi City, Shanxi, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Wan
authors.affiliation: Department of Radiation Oncology, District Hospital of Changzhi City, Shanxi, People's Republic of China.
authors.forename: Xitang
authors.initials: X
authors.lastname: Jia
authors.affiliation: Department of Radiation Oncology, District Hospital of Changzhi City, Shanxi, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Liu
authors.affiliation: Medical Physics Program, School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA. Electronic address: chris.wang@nre.gatech.edu.
authors.forename: C-K Chris
authors.initials: CK
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D002142:Californium / Q000627:therapeutic use*; D002277:Carcinoma / Q000401:mortality / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D004938:Esophageal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009502:Neutrons / Q000627:therapeutic use*; D011829:Radiation Dosage; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D002142:Californium
keywords: Californium-252; Esophageal cancer; High-LET radiotherapy; Neutron brachytherapy