title: Californium-252 neutron brachytherapy combined with external pelvic radiotherapy plus concurrent chemotherapy for cervical cancer: a retrospective clinical study.
abstract: BACKGROUND
  Cervical 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.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  For 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.
authors.affiliation: Department of Oncology, Armed Police Hospital of Guangdong Affiliated with Guangzhou Medical University, No. 268 of Yanling Road, Tianhe District, Guangzhou, 510507, Guangdong, P. R. China. qianshen7@aliyun.com.
authors.forename: Shen
authors.initials: S
authors.lastname: Qian
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, Guangdong, P. R. China.
authors.forename: Ling
authors.initials: L
authors.lastname: Ye
authors.affiliation: Cancer Center of Guangzhou Medical University, Guangzhou, Guangdong, 510095, P. R. China.
authors.forename: Yun-Hong
authors.initials: YH
authors.lastname: Tian
authors.affiliation: Department of Oncology, Armed Police Hospital of Guangdong Affiliated with Guangzhou Medical University, No. 268 of Yanling Road, Tianhe District, Guangzhou, 510507, Guangdong, P. R. China.
authors.forename: Li-Gen
authors.initials: LG
authors.lastname: Wang
authors.affiliation: Department of Oncology, Armed Police Hospital of Guangdong Affiliated with Guangzhou Medical University, No. 268 of Yanling Road, Tianhe District, Guangzhou, 510507, Guangdong, P. R. China.
authors.forename: Zuo-Ping
authors.initials: ZP
authors.lastname: Huang
authors.affiliation: Department of Oncology, Armed Police Hospital of Guangdong Affiliated with Guangzhou Medical University, No. 268 of Yanling Road, Tianhe District, Guangzhou, 510507, Guangdong, P. R. China.
authors.forename: Feng
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Oncology, Armed Police Hospital of Guangdong Affiliated with Guangzhou Medical University, No. 268 of Yanling Road, Tianhe District, Guangzhou, 510507, Guangdong, P. R. China.
authors.forename: Bing
authors.initials: B
authors.lastname: Hou
authors.affiliation: Department of Oncology, Armed Police Hospital of Guangdong Affiliated with Guangzhou Medical University, No. 268 of Yanling Road, Tianhe District, Guangzhou, 510507, Guangdong, P. R. China.
authors.forename: Ni
authors.initials: N
authors.lastname: Song
authors.affiliation: Department of Oncology, Armed Police Hospital of Guangdong Affiliated with Guangzhou Medical University, No. 268 of Yanling Road, Tianhe District, Guangzhou, 510507, Guangdong, P. R. China.
authors.forename: Juan
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Oncology, Armed Police Hospital of Guangdong Affiliated with Guangzhou Medical University, No. 268 of Yanling Road, Tianhe District, Guangzhou, 510507, Guangdong, P. R. China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Oncology, Armed Police Hospital of Guangdong Affiliated with Guangzhou Medical University, No. 268 of Yanling Road, Tianhe District, Guangzhou, 510507, Guangdong, P. R. China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Oncology, Armed Police Hospital of Guangdong Affiliated with Guangzhou Medical University, No. 268 of Yanling Road, Tianhe District, Guangzhou, 510507, Guangdong, P. R. China. wjtaotao2000@126.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001918:Brachytherapy; D002142:Californium / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009502:Neutrons / Q000627:therapeutic use*; D010388:Pelvis; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D002142:Californium; D002945:Cisplatin
keywords: Californium-252; Cervical cancer; External-beam radiotherapy; Neutron brachytherapy