title: Long-term results of combined modality treatment with I-125 implantation for carcinoma of the pancreas.
abstract: From 1981 to 1987, 81 patients with localized, unresectable carcinoma of the pancreas were treated at Thomas Jefferson University Hospital with a combination of intraoperative Iodine-125 implantation, external beam radiation, and peri-operative systemic chemotherapy. Fifty patients had Stage II disease and 31 patients had Stage III disease. Radioactive Iodine-125 seeds were implanted intraoperatively into the tumor to deliver a minimum peripheral dose of 12,000 cGy over one year. This was followed by external beam radiation (50-55 Gy) and systemic chemotherapy (5-FU, Mitomycin-C +/- CCNU). Incidence of peri-operative mortality was 5% (4/81). Early morbidity was observed in 34% of patients and late complications in 32%. A median survival of 12 months and 2- and 5-year survival rates of 21% and 7% were observed. The determinate 2- and 5-year survival rates were 28% and 13%, respectively. The overall 2- and 5-year survival rates with Stage II disease were 27% and 8% and for Stage III disease, 13% and 3%, respectively (p less than 0.05). The determinate 2- and 5-year survival rates were 34% and 19% for Stage II and 19% and 5% for Stage III disease, respectively (p = 0.08). Local control of disease was achieved in 71% of patients. This combined modality approach appears to have achieved satisfactory local control of primary cancer and long term survival of selected patients.
authors.affiliation: Department of Radiation Oncology and Nuclear Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107.
authors.forename: M
authors.initials: M
authors.lastname: Mohiuddin
authors.forename: F
authors.initials: F
authors.lastname: Rosato
authors.forename: D
authors.initials: D
authors.lastname: Barbot
authors.forename: A
authors.initials: A
authors.lastname: Schuricht
authors.forename: W
authors.initials: W
authors.lastname: Biermann
authors.forename: R
authors.initials: R
authors.lastname: Cantor
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000532:radiotherapy / Q000628:therapy*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001918:Brachytherapy; D003131:Combined Modality Therapy; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008130:Lomustine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000532:radiotherapy / Q000628:therapy*; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors
chemical_list: D007457:Iodine Radioisotopes; D016685:Mitomycin; D008130:Lomustine; D005472:Fluorouracil