title: Long-term results for Stage IIIB cervical cancer patients receiving external beam radiotherapy combined with either HDR (252)Cf or HDR (60)Co intracavitary brachytherapy.
abstract: The aim of this work was to compare the long-term curative effects and complications of patients diagnosed with cervical cancer International Federation of Gynecology and Obstetrics IIIB (n = 430) as treated with Californium-252 ((252)Cf) or cobalt-60 ((60)Co) intracavitary brachytherapy (ICBT) combined with external beam radiotherapy (EBRT).
  
  
  
  Cervical cancer cases with a history of treatment with (252)Cf or (60)Co ICBT combined with EBRT were selected from the Lithuanian National Cancer Institute database. Complications and second primary malignancies were compared in both patients groups. Estimates of the 5-, 10-, and 15-year overall survival and disease-free survival rates were computed with the Kaplan-Meier method and a Cox proportional hazards model applied using STATA software.
  
  
  
  At 5, 10, and 15 years, the overall survival rates were 46.9%, 39.3%, and 34.6% for the (252)Cf group and 35.4%, 26.9%, and 22.5% for the (60)Co group (p = 0.004), respectively. The disease-free survival rates were 42.1%, 35.0%, and 31.0% for the (252)Cf group and 32.0%, 25.1%, and 21.4% for the (60)Co group (p = 0.009), respectively. Histopathologic type of adenocarcinoma increased the risk of death for the (252)Cf group (hazard ratio 3.62). Histopathologic tumor type (hazard ratio 7.48) and recurrence (hazard ratio 2.83) were factors that statistically and significantly influenced the patient prognosis for the (60)Co group.
  
  
  
  Applying (252)Cf ICBT with EBRT was effective for International Federation of Gynecology and Obstetrics IIIB cervical cancer patients. Moreover, long-term followup data demonstrated higher survival rates in patients treated with (252)Cf ICBT than (60)Co ICBT. Complications in patients treated with neutron ICBT were not more frequent or severe than those treated with (60)Co ICBT.
authors.affiliation: Radiation and Medical Oncology Center, National Cancer Institute, Vilnius, Lithuania. Electronic address: ulinsko@gmail.com.
authors.forename: K
authors.initials: K
authors.lastname: Ulinskas
authors.affiliation: Radiation and Medical Oncology Center, National Cancer Institute, Vilnius, Lithuania.
authors.forename: E
authors.initials: E
authors.lastname: Janulionis
authors.affiliation: Radiation and Medical Oncology Center, National Cancer Institute, Vilnius, Lithuania.
authors.forename: K P
authors.initials: KP
authors.lastname: Valuckas
authors.affiliation: Scientific Research Center, National Cancer Institute, Vilnius, Lithuania.
authors.forename: V
authors.initials: V
authors.lastname: Samerdokiene
authors.affiliation: Scientific Research Center, National Cancer Institute, Vilnius, Lithuania.
authors.forename: V
authors.initials: V
authors.lastname: Atkocius
authors.affiliation: Department of Radiation Oncology, Tufts University School of Medicine, Boston, MA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Rivard
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002142:Californium / Q000009:adverse effects / Q000627:therapeutic use*; D003037:Cobalt Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000175:diagnosis*; D011879:Radiotherapy Dosage; D015996:Survival Rate; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D003037:Cobalt Radioisotopes; D002142:Californium
keywords: Californium-252; Cervical cancer; Neutron brachytherapy