Maruyama Y, van Nagell J R, Yoneda J, Donaldson E S, Gallion H H, Higgins R, Kryscio R J
Department of Radiation Medicine, University of Kentucky Medical Center, Lexington.
Strahlenther Onkol. 1990 May;166(5):317-21.
252Cf neutron brachytherapy was tested in a feasibility trial for efficacy for cervix cancer therapy vs. high stage radioresistant and subsequently for all stages of disease. Actuarial survival curves were analyzed for 218 patients treated between 1976 and 1983 and followed five to 14 years to the present time. A variety of doses, schedules and methods for brachytherapy was tested during this period, and a dose-response relationship for tumor eradication studied. All treatments were combined with whole-pelvis photon radiotherapy to approximately 45 to 60 Gy. This combination was found effective, particularly if an early implant schedule was used for the Cf implant, followed by whole-pelvis photon radiotherapy. For bulky/barrel shaped low-stage disease in medically fit patients, 252Cf implants were combined with surgery, i.e., extrafascial hysterectomy and was readily usable for treatment without complications and with high cure rates (92% five-year survival). All survivals and outcomes to 13 years match the best results of conventional photon radiotherapy. For all stages better results were observed for bulky, barrel, and advanced-stage tumors, especially for local tumor control, if optimal schedules, doses and implant numbers were used. Knowledge about neutron dose, dose per implant, number of implants and combination with photon beam therapy evolved during the trials. 252Cf represents a new quick acting effective radioisotope for human cancer therapy especially for treatment of radioresistant, bulky and high stage cancers.
对252Cf中子近距离放射疗法进行了一项可行性试验，以评估其在宫颈癌治疗中的疗效，先是针对高分期放射抗拒性宫颈癌，随后针对所有疾病分期。分析了1976年至1983年间接受治疗的218例患者的精算生存曲线，这些患者随访了5至14年直至目前。在此期间测试了多种近距离放射疗法的剂量、方案和方法，并研究了肿瘤根除的剂量反应关系。所有治疗均联合全盆腔光子放疗，剂量约为45至60 Gy。发现这种联合治疗有效，特别是如果对Cf植入采用早期植入方案，随后进行全盆腔光子放疗。对于身体状况良好的体积较大/桶状低分期疾病患者，252Cf植入联合手术，即筋膜外子宫切除术，易于使用且无并发症，治愈率高（五年生存率92%）。所有患者至13年的生存率和结局与传统光子放疗的最佳结果相当。对于所有分期，对于体积较大、桶状和晚期肿瘤，尤其是局部肿瘤控制，如果采用最佳方案、剂量和植入次数，观察到更好的结果。在试验过程中，关于中子剂量、每次植入剂量、植入次数以及与光子束治疗联合应用的知识不断发展。252Cf是一种新型速效有效的放射性同位素，用于人类癌症治疗，尤其适用于治疗放射抗拒性、体积较大和高分期癌症。
