Second primary malignancies after radiotherapy including HDR ²⁵²Cf brachytherapy for cervical cancer

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• 作者：Vitalija Samerdokiene¹ ; ^{vitalija.samerdokiene@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Konstantinas Povilas Valuckas² ; Ernestas Janulionis² ; Vydmantas Atkocius¹ ; Mark J. Rivard³
• 关键词：Second primary malignancies ; Cervical cancer ; 252Cf brachytherapy
• 刊名：Brachytherapy
• 出版年：2015
• 出版时间：November-December 2015
• 年：2015
• 卷：14
• 期：6
• 页码：898-904
• 全文大小：247 K

文摘

Second primary malignancies (SPMs) are among the most serious late adverse effects after radiotherapy experienced over time by the increasing population of cancer survivors worldwide. The study aim was to determine the rate and distribution of SPMs for neutron- and photon-emitting brachytherapy (BT) sources for patients treated for cervical cancer.

Methods and Materials

The cohort comprised 662 patients with invasive cervical cancer (Stages IIB and IIIB) and contributed 5,224 patient-years (PY) of observation. These patients were treated by radiotherapy during the 1989–1999 year period with cobalt-60 source (⁶⁰Co) teletherapy. The first group of patients (N = 375; 3,154 PY) received high-dose-rate (HDR) californium-252 source (²⁵²Cf) BT, whereas the second group (N = 287; 2,070 PY) received HDR ⁶⁰Co BT.

Results

Over a 25-year period, 35 SPMs were observed, amounting to 5.3% of all observed patients: in 16 (2.4%) heavily, 2 (0.3%) moderately, 14 (2.1%) lightly irradiated body sites, and 3 (0.5%) other sites. Of these, 21 cases (5.6%) were observed in the HDR ²⁵²Cf BT group, whereas 14 cases (4.9%) were observed in the HDR ⁶⁰Co BT group. Exposures received during ⁶⁰Co teletherapy and HDR BT with either ²⁵²Cf or ⁶⁰Co had statistically equivalent (p = 0.68) effects on SPM development.

Conclusions

Cure rates are improving, and therefore, there are more long-term survivors from cervical cancer. This study shows no significant difference in rates or distribution of SPMs in women treated with neutron BT compared with photon BT (p = 0.68). After reviewing related literature and our research results, it is evident that a detailed investigation of SPM frequency, localization, and dose to adjacent organs is a suitable topic for further research.