Long-Term Results In Cervical And Uterine Cancer Patients Treated With Combined Photon And Neutron Radiotherapy

During the long period of time radiation therapy used to cure oncological diseases can cause second primary malignancies (SPM) . In this investigation the spread of SPM was evaluated between 1143 pts treated with radiation therapy (RT) during the period of 1989-1999 with cervix uteri stage II B and III B and corporis uteri stages I-III. One group of pts ( N=538 ) was irradiated with external 60Co gamma therapy and high dose rate (HDR) photon 60Co brachytherapy,another (N=605) with 60Co external gamma therapy and HDR 252Cf neutron brachytherapy. There are enough data about frequency of SPM after external 60Co gamma therapy, SPM location and delivery dose. Data about frequency of SPM after neutron 252Cf brachytherapy was not found. Our 25 years follow-up of pts received HDR photon 60Co or neutron 252Cf brachytherapy revieled that in 1143 cases 83(7.26 %) SPM were diagnosed. 46 (4.02%) of them were treated with neutron 252Cf brachytherapy, 37 (3.24%) with gamma 60Co brachytherapy (where was no significant statistical difference: p=0.554). The frequency of SPM in Lithuanian population irradiated with gamma 60Co or neutron 252Cf brachytherapy was similar with the data from other countries. Survival of localy spread II B cancer stage was the same in both brachytherapy groups. Stage III B pts had significant better survival with neutron 252Cf brachytherapy (difference 10-12 %: p=0.004). The largest frequences of SPM was noticed in heavy and low irradiated anatomic sites. In medium irradiated doses SPM were rare. Recurrences were found statistically significant less in group treated with 252Cf brachytherapy. Three publications in ISI base journals were published (two-Q-1 and one Q-2 level).