Intraoperative radiotherapy in pancreatic cancer: a systematic review.
OBJECTIVE
Intraoperative radiotherapy (IORT) has been considered for treatment of pancreas cancer since local recurrence rates are very high. This study assesses the efficacy and safety of IORT in pancreatic cancer.


METHODS
We conducted a systematic review of scientific literature from January 1995 to February 2007, including Medline, Embase, ISI Web of Science and HTA (Health Technology Assessment). By applying a series of inclusion criteria, two independent reviewers selected those studies in which a minimum of 30 patients received IORT and which furnished survival results based on a minimum 3-month follow-up.


RESULTS
Fourteen papers were included, one was an IORT assessment report, 5 were cohort studies, and the remaining 8 were case series studies, 2 of which belonged to the same series. In general, these studies showed that IORT could slightly increase survival among patients with pancreatic cancer in localized stages. However, the results were not conclusively in favor of IORT in the case of pancreatic cancer in locally advanced and metastatic stages. There were no published studies that assessed quality of life.


CONCLUSIONS
There is no clear evidence to indicate that IORT is more effective than other therapies in treating pancreatic cancer in locally advanced and metastatic stages.
Ruano-Ravina
Alberto
A
Galician Agency for Health Technology Assessment, Galician Health Authority, Santiago de Compostela, Spain, Spain. alberto.ruano.ravina@sergas.es
Almazán Ortega
Raquel
R
Guedea
Ferrran
F
D003131:Combined Modality Therapy; D006801:Humans; D007432:Intraoperative Period; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome