title: Effect of intraoperative radiotherapy combined with external beam radiotherapy following internal drainage for advanced pancreatic carcinoma.
abstract: OBJECTIVE
  To determine the survival of advanced pancreatic cancer patients treated with intraoperative radiotherapy (IORT) combined with external beam radiation therapy (EBRT) following internal drainage (cholecystojejunostomy or choledochojejunostomy).
  
  
  METHODS
  Eighty-one patients with advanced pancreatic cancer who received IORT combined with EBRT following internal drainage (ID) between 1996 and 2001 were retrospectively analyzed. Among the 81 patients, 18 underwent ID+IORT, 25 ID+IORT+EBRT (meanwhile, given 5-Fu 300 mg/m(2) i.v. drip, 2f/w), 16 EBRT, 22 had undergone simple internal drainage. The IORT dose was 15-25Gy in a single fraction. The usual EBRT dose was 30-40Gy with a daily fraction of 1.8-2.0 Gy.
  
  
  RESULTS
  The complete remission rate, partial remission rate of patients with backache and abdominal pain treated with ID+IORT were 55.5%, 33.3% respectively. Alleviation of pain was observed 2 or 3 wk after IORT. The median survival time (MST) of ID+IORT group was 10.7 mo. The pain remission rate of patients treated with ID+IORT+EBRT was 92%, and their MST was 12.2 mo. The MST of patients treated with EBRT and simple internal drainage was 5.1 mo and 7.0 mo, respectively. The survival curve of ID+IORT group and ID+IORT+EBRT group was significantly better than that of EBRT group (P<0.05). The difference between the ID+IORT+EBRT group and ID group was significant (P<0.05).
  
  
  CONCLUSIONS
  IORT combined with EBRT following internal drainage can alleviate pain, improve quality of life and prolong survival time of patients with advanced pancreatic cancer.
authors.affiliation: Department of Oncology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China. m68d69@pub.xaonline.com
authors.forename: Hong-Bing
authors.initials: HB
authors.lastname: Ma
authors.forename: Zheng-Li
authors.initials: ZL
authors.lastname: Di
authors.forename: Xi-Jing
authors.initials: XJ
authors.lastname: Wang
authors.forename: Hua-Fen
authors.initials: HF
authors.lastname: Kang
authors.forename: Huai-Ci
authors.initials: HC
authors.lastname: Deng
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Bai
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000401:mortality / Q000532:radiotherapy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D011182:Postoperative Care; D012074:Remission Induction; D016019:Survival Analysis