title: Combined treatment using radiotherapy for carcinoma of the pancreas involving the adjacent vessels.
abstract: The prognosis of pancreatic duct carcinoma is determined mainly by the degree of local invasion, particularly of the portal system and/or associated arteries supplying the carcinoma. Intraoperative (25-36.5 Gy of betatron) and/or external (14.4-25.6 Gy, preoperatively, and 24-61.2 Gy, postoperatively, using lineac photon beams) radiotherapy was combined with pancreatectomy or by-pass surgery for patients with pancreatic carcinoma involving the surrounding vessels but with no distant metastases. Twelve- and 24-month survival rates were 25.9% and 3.2%, respectively, in patients with pancreatectomy (n = 35) and 6.4% and 0%, respectively, in patients with by-pass operations (n = 32). However, in patients with combined surgery and radiotherapy the prognosis was markedly improved to 12- and 24-month survival rates of 33.5% and 20.1%, respectively, for patients with pancreatectomy (n = 13) and rates of 25% and 13%, respectively, for patients with by-pass operations (n = 8). Moreover, radiotherapy produced a significant advantage for local control of pain in patients with unresectable pancreatic carcinoma. This suggests that combined treatment using radiotherapy will be a valuable therapeutic improvement for patients presenting advanced pancreatic carcinoma with vessel involvement.
authors.affiliation: First Department of Surgery, Faculty of Medicine, Kyoto University, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Manabe
authors.forename: N
authors.initials: N
authors.lastname: Baba
authors.forename: A
authors.initials: A
authors.lastname: Nonaka
authors.forename: N
authors.initials: N
authors.lastname: Asano
authors.forename: K
authors.initials: K
authors.lastname: Yamaki
authors.forename: Y
authors.initials: Y
authors.lastname: Shibamoto
authors.forename: M
authors.initials: M
authors.lastname: Takahashi
authors.forename: M
authors.initials: M
authors.lastname: Abe
authors.forename: T
authors.initials: T
authors.lastname: Tobe
mesh_terms: D002285:Carcinoma, Intraductal, Noninfiltrating / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D007430:Intraoperative Care; D009361:Neoplasm Invasiveness; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D011379:Prognosis