title: Intraoperative radiation therapy for pancreatic adenocarcinoma: the Komagome hospital experience.
abstract: We analyzed 144 patients with pancreatic adenocarcinoma who had received intraoperative radiation therapy (IORT) in combination with external beam radiation therapy (EBRT) within the past 20 years. The patients were divided into 2 groups: group 1 contained 65 patients with locally unresectable tumors who underwent bypass operations and group 2 contained 68 patients with resectable tumors who underwent pancreatic resection. As a pilot study, we performed additional arterial infusion chemotherapy after changing peripancreatic hemodynamics during EBRT in the remaining 11 patients. The 30 patients who received R0 resection had the best survival rates (3-year survival rate of 35.4%), while 3 patients with stage III disease survived more than 5 years. The survival of group 1 patients nearly equaled that of group 2 patients who underwent R1 or R2 resection (median survival, 10.9 vs. 11.1 months, respectively; P = 0.43). The 1-year survival rate for the 11 patients receiving arterial infusion chemotherapy was 45.4%, and 5 patients survived over 1 year without developing hepatic metastasis or regrowth of primary tumors. The survival benefits obtained using this form of radiotherapy are apparently limited. On the other hand, additional arterial infusion chemotherapy employing a new drug delivery system using hemodynamic change does appear promising.
authors.affiliation: Department of Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan. atsu.oka@cick.jp
authors.forename: Atsutake
authors.initials: A
authors.lastname: Okamoto
authors.forename: Gaku
authors.initials: G
authors.lastname: Matsumoto
authors.forename: Koji
authors.initials: K
authors.lastname: Tsuruta
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Baba
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Karasawa
authors.forename: Terumi
authors.initials: T
authors.lastname: Kamisawa
authors.forename: Naoto
authors.initials: N
authors.lastname: Egawa
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D007432:Intraoperative Period; D007564:Japan; D008113:Liver Neoplasms / Q000517:prevention & control / Q000556:secondary; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D010146:Pain / Q000175:diagnosis; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate; D017211:Treatment Failure