Objective: To investigate the surgical therapeutic efficacy of uterine tumors patients underwent Cf-252 neutron intra-cavity and external radiotherapy, and evaluate the application value of Cf-252 neutron radiotherapy. Methods: Thirteen cases of uterine tumor with local suspicious lesions or poor prognostic factors after CF-252 neutron intracavity and external radiotherapy were treated with surgery. Among them, 12 cases underwent extrafascial hysterectomy, 1 case underwent extensive hysterectomy and lymphadenectomy. The postoperative pathology and follow-up results were used to evaluate the efficacy. Results: Nine cases showed severe response to radiotherapy in postoperative cervical pathological tissues without residual tumor, and survived for more than 3-14 years, the median survival time was 8 years. All of 4 cases with residual tumor died within 1 year. Delayed healing of vaginal wounds occurred in 3 of the 12 cases. Conclusions: Cf-252 is a good brachytherapy source. The cervical tissue shows severe response to radiotherapy and prolonged healing time of vaginal wound is observed in some cases after CF-252 radiotherapy. To those uterine tumor patients with local suspicious lesions or poor prognostic factors after CF-252 neutron intracavity and external radiotherapy, extrafascial hysterectomy is a safe and feasible treatment method.
目的： 分析子宫肿瘤患者接受锎-252中子腔内和体外放疗后手术结果，评估锎-252中子治疗的价值。 方法： 对13例接受锎-252中子腔内放疗及体外照射后、局部可疑肿瘤未控制或具有预后不良因素的子宫肿瘤患者，进行手术治疗。12例行筋膜外子宫切除，1例行子宫广泛切除＋淋巴清扫。依据术后病理和随访结果进行疗效评价。 结果： 9例患者术后宫颈病理组织呈重度放疗反应，无肿瘤残存，生存时间为3～14年，中位生存时间8年；4例术后病理有肿瘤残存，均在1年内死亡。12例患者中，3例阴道伤口延迟愈合。 结论： 锎-252为较好的近距离放射源，使用锎-252放疗后宫颈组织反应较重，部分患者阴道伤口愈合时间延长。对于接受锎-252中子腔内放疗及体外照射后、局部仍存在可疑肿瘤未控制或具有预后不良因素的子宫肿瘤患者，筋膜外子宫切除术是安全可行的治疗方法。.
Keywords: Cf-252 brachytherapy; Endometrial neoplasms; Surgery; Uterine neoplasms.