A review of californium-252 neutron brachytherapy for cervical cancer
- University of Kentucky Medical Center, Lexington (USA)
Since 1976 a clinical trial has been conducted to test the feasibility, the potential, and to develop methods for using the neutron-emitting radioactive isotope, californium-252 (Cf-252), for the treatment of cervical cancer. A total of 218 patients were treated in the initial study period from 1976 until 1983. The trials initially treated advanced cervical cancer patients using different doses and schedules; they were extended to include unfavorable presentations of Stages 1 and 2 because of favorable results in the initial trials. The authors began to treat patients with Stage IB bulky or barrel-shaped tumors and the majority were treated with both radiation and hysterectomy. Actuarial survival was determined for Stage IB disease and was 87% at 5 years and 82% at 10 years. For those tested with preoperative radiation it was 92% at 5 and 87% at 10 years. For Stage 2, it was 62% 5 years and 61% at 10. Survival 5 years after combined radiation and surgical therapy for Stage 2 disease was 68%. For Stage 3, it was 33% at 5 years and 25% at 10. However, 5-year survival using the early neutron implant was 46% versus approximately 19% for delayed Cf-252 or cesium 137. Different schedules and sequences of neutrons and photons greatly altered outcome. Neutron treatment before external photon therapy was better for all stages of disease. Only about 5% of all patients developed complications after neutron therapy. No hematologic or mesenchymal second tumors were observed. Neutron brachytherapy was found to be very effective for producing rapid response and greatly improved local control of bulky, barrel, or advanced cervical cancers. The clinical trial identified and evolved schedules, doses, doses per session, and developed methods different from standard photon therapy but highly effective for local control and cure of cervical cancers of all stages.
- OSTI ID:
- 5227992
- Journal Information:
- Cancer (Philadelphia); (United States), Vol. 68:6; ISSN 0008-543X
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
CARCINOMAS
NEUTRON THERAPY
UTERUS
CALIFORNIUM 252
FEASIBILITY STUDIES
PATIENTS
RADIATION DOSES
RADIATION SOURCE IMPLANTS
SURGERY
SURVIVAL CURVES
ACTINIDE ISOTOPES
ACTINIDE NUCLEI
ALPHA DECAY RADIOISOTOPES
BODY
CALIFORNIUM ISOTOPES
DISEASES
DOSES
EVEN-EVEN NUCLEI
FEMALE GENITALS
HEAVY NUCLEI
IMPLANTS
ISOTOPES
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
NUCLEI
ORGANS
RADIATION SOURCES
RADIOISOTOPES
RADIOLOGY
RADIOTHERAPY
SPONTANEOUS FISSION RADIOISOTOPES
THERAPY
YEARS LIVING RADIOISOTOPES
550603* - Medicine- External Radiation in Therapy- (1980-)