Comparison of the efficacy of Cf-252 neutron intracavitary brachytherapy monotherapy with neutron intracavitary brachytherapy plus external beam radiotherapy in stage IB1 cervical cancer

Objective: We aimed to compare the efficacy of californium (Cf)-252 neutron intracavitary brachytherapy (NIBT) monotherapy with NIBT plus external beam radiotherapy (ERBT) in the treatment of stage IB1 cervical cancer. Methods: From May 2006 to March 2014, 38 patients with stage IB1 cervical cancer with negative pelvic lymph node metastasis (NPLNM) who were treated at our hospital were enrolled in this retrospective study. A matchedpair design based on age, hemoglobin level, and tumor histology was used for the analysis. The status of all patients was assessed by the positron emission tomography - computer tomography (PET-CT) scan or the contrast enhancement pelvic CT scan. Cf-252 NIBT was administered for four times, and the total dose at point A was 42-44 Gy. Results: The local tumor control rate, overall survival rate, tumor-free survival rate, and late complication incidence rate in the NIBT group were 94.7%, 100%, 94.7% and 0%, respectively, which in the EBRT + NIBT group were 94.7%, 89.5%, 89.5% and 5.26%, respectively. The return of menstruation incidence rate was 36.8% in the NIBT group and 0% in the EBRT + NIBT group. Conclusion: The treatment outcomes in the NIBT group were similar to those in the EBRT + NIBT group for patients with stage IB1 cervical cancer with NPLNM, regular menstruation and at least 3 years of follow-up data. The additional advantage of NIBT monotherapy is the potential preservation of ovarian and endometrial function and hence fertility.