Spasokukotskaya O N, Shabanov M A, Merkle Kh
Arch Geschwulstforsch. 1986;56(4):249-56.
The effects of Cf-252 and Co-60 radiation have been compared by investigating radiation response and radiation pathomorphosis of the cervical carcinoma and surrounding normal tissue. The effectiveness of radiotherapy treatment was evaluated by comparison of Cf-252 and Co-60 irradiated patients (each arm 18 patients) with a non-irradiated control group (15 patients), suffering from epithelium carcinomas of the cervix uteri. The total dose in point A was 60 isoGy in either case given in 3 fractions at 28 days using the after-loading units "ANET" (neutrons) and "AGAT V" (gamma). Two to three weeks after irradiation, extended extirpation of the uterus and its adnexa was performed. The therapeutic effect was strongest in both comparative groups with superficially located exophytic forms of the cervical carcinoma and with carcinoma in situ. With invasive growth forms, signs of therapeutic pathomorphosis were found in both groups predominantly in the superficial tumor areas. However, the extent of the remaining tumor complexes was much greater with Co-60 than with Cf-252 radiation. Adenocarcinomas were more sensitive to Cf-252 independently of the invasion depth of the tumor. The observed alterations in the surrounding normal tissue of the uterus, both in the immediate proximity of the Cf-252 source (endometrium) and at some distance (myometrium, perimetrium) reflect the more severe alterations following irradiation as compared with Co-60. The lower values of the volume density of the tumor parenchyma remaining after radiotherapy and the high damage index (95.5%) give evidence for the pronounced biological and therapeutic effectiveness of high dose rate Cf-252-radiation. They allow to expect improvement of late results in the treatment of patients with epithelium carcinoma of the cervix uteri, and it seems to be reasonable to make further studies in that direction.
通过研究子宫颈癌及其周围正常组织的辐射反应和辐射病理形态变化，比较了Cf - 252和Co - 60辐射的效果。通过比较Cf - 252和Co - 60照射患者（每组18例）与未照射对照组（15例）子宫颈上皮癌患者的情况，评估放射治疗的有效性。在两种情况下，A点的总剂量均为60等剂量Gy，使用“ANET”（中子）和“AGAT V”（γ射线）后装装置，在28天内分3次给予。照射后两到三周，进行子宫及其附件的扩大切除。在两个比较组中，对于浅表外生性子宫颈癌形式和原位癌，治疗效果最强。对于浸润性生长形式，两组主要在浅表肿瘤区域发现治疗性病理形态变化的迹象。然而，Co - 60照射后剩余肿瘤复合体的范围比Cf - 252辐射大得多。腺癌对Cf - 252更敏感，与肿瘤的浸润深度无关。观察到子宫周围正常组织的变化，无论是在Cf - 252源附近（子宫内膜）还是在一定距离处（肌层、子宫浆膜层），与Co - 60相比，照射后变化更严重。放射治疗后剩余肿瘤实质的体积密度较低值和高损伤指数（95.5%）证明了高剂量率Cf - 252辐射具有显著的生物学和治疗效果。它们使得有望改善子宫颈上皮癌患者的远期治疗效果，并且朝着该方向进一步开展研究似乎是合理的。
