Abstract
Eighty patients with pancreatic carcinoma were treated by intraoperative radiotherapy (IORT) with or without surgical resection of the tumor, and the results were compared with those of 111 patients treated by surgery alone. For resectable patients, the radiation dose was 30 Gy and the average field sizes were 8 or 10 cm; for unresectable patients, these values were 20–30 Gy and 6 or 8 cm, respectively. No side effects of IORT were observed. In 49 resectable stage III patients, the IORT group (n=16) had a higher survival rate than the non-IORT group (n=33); i.e., 1-year survival rates of 44.6% vs 23% and 2-year survival rates of 37.2% vs 7.7% after surgery (P<0.05). However, there was no significant difference in survival rate between the IORT group (n=28) and the non-IORT group (n=29) in 57 resectable patients in stage IV. In unresectable patients, the IORT group (n=31) (P<0.05) had a higher survival rate than the non-IORT group (n=38) (P<0.05). The palliative effect of IORT on abdominal or back pain was evaluated in 15 patients who had such symptoms and did not undergo tumor resection. Overall, pain decreased or disappeared in 13 of these patients (87%).
Similar content being viewed by others
References
Nakao A, Horisawa M, Suenaga M, Yamamoto T, Kondo T, Kawase S, Nagaoka S, Mori Y (1982 Temporal portasystemic bypass with the use of the heparinized hydrophilic catheter. Jpn J Artif Organs 11:962–965
Nakao A, Kondo T (1983) New technique of radical pancreatectomy with the use of the heparinized hydrophilic bypasscatheter of the portal vein. Jpn J Artif Organs 12:697–700
Nakao A, Horisawa M, Kondo T, Ando H, Kishimoto W, Ichihara T, Sako T, Takimoto H, Ito N (1983) Total pancreatectomy accompanied by portal vein resection using catheterbypass between mesenteric and femoral veins. Shujutsu (Operation) 37:1–6
Nakao A, Nonami T, Harada A, Kasuga T, Takagi H (1990) Portal vein resection with a new antithrombogenic catheter. Surgery 108:913–918
Japan Pancreas Society (1986) General rules for cancer of the pancreas, 3rd edn, Kanehara, Tokyo
Abe M, Takahashi M (1981) Intraoperative radiotherapy: The Japanese experience. Int J Radiat Oncol Biol Phys 7:863–868
Kalser MH, Ellenberg SS (1985) Pancreatic cancer. Adjuvant combined radiation and chemotherapy following curative resection. Arch Surg 120:899–903
Hiraoka T, Watanabe E, Mochinaga M, Tashiro S, Miyauchi Y, Nakamura I, Yokoyama I (1984) Intraoperative irradiation combined with radical resection for cancer of the head of the pancreas. World J Surg 8:766–771
Shibamoto Y, Manabe T, Baba N, Sasai K, Takahashi M, Tabe T, Abe M (1990) High dose, external beam, and intraoperative radiotherapy in the treatment of resectable and unresectable pancreatic cancer. Int J Radiat Oncol Biol Phys 19:605–611
Tepper JE, Shipley WU, Warshaw AL, Nardi GL, Wood WC, Orlow EL (1987) The role of misonidazole combined with intraoperative radiation therapy in the treatment of pancreatic carcinoma. J Clin Oncol 5:579–584
Tuckson WB, Goldson AL, Ashayeri E, Halyard-Richardson M, Dewtty RL, Leffall L Jr (1988) Intraoperative radiotherapy for patients with carcinoma of the pancreas. The Howard University Hospital experience, 1978–1986. Ann Surg 207:648–654
Dobelbower RR Jr, Howard JM, Bange FR, Eltaki A, Merrick HW III (1989) Treatment of cancer of the pancreas by precision high dose (PHD) external photon beam and intraoperative electron beam therapy (IOEBT). Int J Radiat Oncol Biol Phys 16:205–209
Heijimans HJ, Hoekstra HJ, Mehta DM (1989) Is adjuvant intra-operative radiotherapy (IORT) for resectable and unresectable pancreatic carcinoma worthwhile. Hepatogastroenterology 36:474–477
Ahmadu-Suka F, Gillette EL, Withrow SJ, Husted PW, Nelson AW, Whiteman CE (1988) Exocrine pancreatic function following intraoperative irradiation of the canine pancreas. Cancer 62:1091–1095
Poulakos L, Elwell JH, Osborne JW, Urdante LF, Hauer-Jensen M, Vigliotti AP, Hussey DH, Summers RW (1988) Intraoperative irradiation in a rat model: Histopathological changes in irradiated segments of duodenum. J. Surg Oncol 38:130–135
Hoeska HJ, Restrepo C, Kinsella TJ, Sindelar WF (1988) Histopathological effects of intraoperative radiotherapy on pancreas and adjacent tissues: A postmortem analysis. J Surg Oncol 37:104–108
Author information
Authors and Affiliations
Additional information
Offprint requests to: A. Nakao
About this article
Cite this article
Nakao, A., Harada, A., Nonami, T. et al. Intraoperative radiotherapy for resectable and unresectable pancreatic carcinoma. J Hep Bil Pancr Surg 1, 252–256 (1994). https://doi.org/10.1007/BF02391076
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02391076