title: Californium versus cobalt brachytherapy combined with external-beam radiotherapy for IIB stage cervical cancer: long-term experience of a single institute.
abstract: OBJECTIVE
  The purpose of this paper was to observe and compare long-term curative effects and complications of FIGO stage IIB cervical cancer patients (n = 232) treated with high-dose-rate (HDR) californium ((252)Cf) neutron or cobalt ((60)Co) photon intracavitary brachytherapy (ICBT) combined with external-beam radiotherapy (EBRT).
  
  
  METHODS
  The EBRT dose to the small pelvis was 50 Gy in both groups. The brachytherapy component of (252)Cf or (60)Co was added in the 3(rd) week of EBRT, 5 fractions were performed once per week resulting in a total ICBT dose of 40 Gy/Gyeq (point A).
  
  
  RESULTS
  Overall survival (OS) at 5, 10 and 15 years was 63.6%, 50.4% and 38.8% in the (252)Cf group and 62.2%, 50.5%, 39.9%, in the (60)Co group, respectively (p = 0.74). The percentage of tumour recurrence was statistically significantly lower in the (252)Cf group with 7.4% versus 17.1% in the (60)Co group (p = 0.02). Second primary cancers have developed similarly 9.1% and 8.1% cases for (252)Cf and (60)Co groups, respectively.
  
  
  CONCLUSIONS
  Our long-term retrospective study comparing (252)Cf and (60)Co isotopes with brachytherapy in combined treatment of FIGO IIB stage cervix carcinoma patients shows, that overall survival in the both groups are similar. However, the recurrence of tumour was significantly lower in the (252)Cf group. The incidence of second primary cancers was similar in both groups.
authors.affiliation: Radiotherapy and Drug Center.
authors.forename: Ernestas
authors.initials: E
authors.lastname: Janulionis
authors.affiliation: Radiotherapy and Drug Center.
authors.forename: Konstantinas Povilas
authors.initials: KP
authors.lastname: Valuckas
authors.affiliation: Radiotherapy and Drug Center.
authors.forename: Sarune
authors.initials: S
authors.lastname: Liukpetryte
authors.affiliation: Scientific Research Center, National Cancer Institute, Vilnius, Lithuania.
authors.forename: Vitalija
authors.initials: V
authors.lastname: Samerdokiene
authors.affiliation: Scientific Research Center, National Cancer Institute, Vilnius, Lithuania.
authors.forename: Vydmantas
authors.initials: V
authors.lastname: Atkocius
keywords: 252Cf; 60Co; brachytherapy; cervical cancer; neutron brachytherapy