Intraoperative Radiation Therapy in Combination with Conformation Radiation Therapy for Localized Unresectable Pancreatic Carcinoma -An Analysis of 13 Patients Survived for More than One Year-

Atsutake Okamoto, Kohji Tsuruta, Yoshiaki Tanaka*, Tokio Onodera**

Department of Surgery and Radiotherapy*, Tokyo Metropolitan Komagome Hospital
**Tokyo Metropolitan Fuchu Hospital

The present report is a retrospective analysis of the effect of intraoperative radiation therapy (IORT) for localized but unresectable pancreatic carcinoma. Thirteen of 30 patients treated by IORT in combination with external beam radiation therapy (EBRT) survived for more than one year. The longest survival period, attained by two patients, was 20 months. The 1, and 1.5-year survival rates were 46.5% and 20.8%, respectively, with a median survival of 11 months, whereas the 1-year survival rate was 0%, with a median survival of 6.2 months for the 16 patients treated by IORT alone (N=16). There was a statistically significant difference in survival rate between the two groups (p<0.01). Therefore, additional EBRT may be indispensable for prolongation of the survival period. Moreover, IORT conferred the palliative benefit of relief of pain in more than half of the patients with severe pain. In postmortem examination of seven patients who survived for more than one year, the tumors were replaced by fibrous and hyalinized tissue, as a result of the effect of IORT, and degeneration and necrosis of tumor cells were seen in the center of the tumor, while viable tumor cells remained in the periphery, spreading to the retroperitoneal tissues or neighborng organs. These histopathological findings are distinctive features of carcinoma of the pancreas treated by IORT.

Key words
unresectable pancreatic carcinoma, intraoperative radiation therapy, conformation radiation

Reprint requests
Atsutake Okamoto Department of Surgery, Tokyo Metropolitan Komagome Hospital
3-18-11 Honkomagome, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
December 10, 1991

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