Lei Xin, Shan Jin-lu, Tang Cheng, Zhao Ke-wei
Cancer Center, Third Affiliated Hospital, Third Military Medical University, Chongqing 400042, China.
Zhonghua Fu Chan Ke Za Zhi. 2007 Nov;42(11):733-6.
To observe the three year local control rate, overall survival rate, complications and prognostic factors of endometrial cancer treated with (252)Cf neutron intracavitary brachytherapy (ICBT) and external beam radiotherapy (EBRT).
Forty endometrial cancer patients staged Ib - IVa by the standard of Federation of International Gynecologic Organization (FIGO), who had not received any treatment were enrolled in this study. Treatment schedules were: (252)Cf ICBT, 10 - 13 Gy(i)/fraction per week, the total dose to point A and point F 35 - 45 Gy(i) and 38 - 50 Gy(i) respectively in 4 fractions. The EBRT was given to the whole pelvic field, with 6 MV or 8 MV X-ray, 2 Gy per fraction, 4 times per week. The total dose was 45 to 50 Gy (the field was blocked 4 cm after 20 - 30 Gy), the total treatment time was 5 - 6 weeks.
The follow-up time was 36 - 96 months, with an average of 42 months. The three year local control and overall survival rate was 88% (35/40) and 75% (30/40) respectively for all patients. Of those patients of stage Ib, they were 93% (14/15) and 87% (13/15), respectively, higher than stage II [80% (12/15), 87% (13/15); P > 0.05], significantly higher than stage III, IV [60% (6/10), 50% (5/10); P < 0.01]. Three year local control and overall survival rate of G(1) grade was 92% (23/25) and 88% (22/25) respectively, significantly higher than G(2) - G(3) grade [80% (12/15), 53% (8/15); P < 0.01]. Three year local control and overall survival rate of adenocarcinoma was 93% (28/30) and 87% (26/30) respectively, significantly higher than squamous adenocarcinoma and papillary adenocarcinoma [70% (7/10), 30% (3/10); P < 0.01]. The grade 2 late radiation cystitis was 2% (1/40), and grade 2, 3 radiation proctitis and sigmoiditis were 10% (4/40).
Combined (252)Cf ICBT and EBRT may be safe and effective for advanced endometrial cancer. The most important prognostic factors were stage, pathological type and differentiation of endometrial cancer.
观察采用²⁵²Cf中子腔内近距离放疗（ICBT）联合体外照射放疗（EBRT）治疗子宫内膜癌的3年局部控制率、总生存率、并发症及预后因素。
选取40例按照国际妇产科联盟（FIGO）标准分期为Ib - IVa期且未接受过任何治疗的子宫内膜癌患者纳入本研究。治疗方案为：²⁵²Cf ICBT，每周10 - 13 Gy(i)/分次，A点和F点总剂量分别为35 - 45 Gy(i)和38 - 50 Gy(i)，共4次。EBRT照射全盆腔野，采用6 MV或8 MV X线，每次2 Gy，每周4次。总剂量为45至50 Gy（20 - 30 Gy后缩野4 cm），总治疗时间为5 - 6周。
随访时间为36 - 96个月，平均42个月。所有患者的3年局部控制率和总生存率分别为88%（35/40）和75%（30/40）。Ib期患者的局部控制率和总生存率分别为93%（14/15）和87%（13/15），高于II期[80%（12/15），%（13/15）；P > 0.05]，显著高于III、IV期[60%（6/10），50%（5/10）；P < 0.01]。G(1)级的3年局部控制率和总生存率分别为92%（23/25）和88%（22/25），显著高于G(2) - G(3)级[80%（12/15），53%（8/15）；P < 0.01]。腺癌的3年局部控制率和总生存率分别为93%（28/30）和87%（26/30），显著高于鳞腺癌和乳头状腺癌[70%（7/10），30%（3/10）；P < 0.01]。2级放射性膀胱炎发生率为2%（1/40），2、3级放射性直肠炎和乙状结肠炎发生率为10%（4/40）。
²⁵²Cf ICBT联合EBRT治疗晚期子宫内膜癌可能安全有效。最重要的预后因素是子宫内膜癌的分期、病理类型和分化程度。
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