[Combination of external beam radiotherapy and 252Cf neutron intracavitary brachytherapy for cervical cancer]

To evaluate the curative effect of 252Cf brachytherapy on advanced cervical cancers.

A total of 77 cervical cancer patients were staged into IIa-IVa according to the standard of International Federation of Gynecology and Obstetrics (FIGO), including 13 cases of stage IIa, 32 of stage IIb, 18 of stage IIIa, 10 of stage IIIb, and 4 of stage IVa. 252Cf brachytherapy was delivered at 8-11 Gy/fraction per week, the total dose of reference point A was 36-45 Gy in 4-5 fractions. The whole pelvic cavity was irradiated with 6 MV X-ray, 200 cGy/fraction, 4 times per week. The total dose of external beam radiotherapy was 45-50 Gy (the center of whole pelvic field was blocked by 4 cm in width after 20-36 Gy), the total treatment course was 5-6 weeks. The 3-year survival rate and late complication rate in bladder and rectum were evaluated.

The local control rate of all patients after 3-year was 94% (72/77); the overall survival rate was 82% (63/77). In particular, the 3-year survival rate was 85% (11/13) for stage IIa, 94% (30/32) for stage IIb, 78% (14/18) for stage IIIa, 70% (7/10) for stage IIIb, 25% for stage IVa cancers. The late complication rate was 3% for cystitis, 5% for proctitis.

Combination of 252Cf brachytherapy and external beam radiotherapy can be well-tolerated by cervical cancer patients. The 3-year survival rate for stage II and III patients is high and late complication rate in bladder and rectum is low.