INTRAOPERATIVE RADIATION-THERAPY FOR PANCREATIC-CARCINOMA - THE CHOICE OF TREATMENT MODALITY

Ninety patients with carcinoma of the pancreas treated between 1976 an d 1990 were reviewed retrospectively. Intraoperative radiation therapy (IORT) in combination with external beam radiation therapy (EBRT) for localized but unresectable tumors (n = 29) prolonged survival signifi cantly more than IORT atone (n = 16) (p < 0.01); it seems EBRT enhance d or contributed to the better results obtained with IORT plus EBRT. M oreover, IORT, alone or in combination, relieved pain. Adjuvant IORT f or residual tumors (n = 20) might not effectively prolong survival, be cause the difference in survival rate between noncurative resection pl us IORT and nonresection plus IORT in combination with EBRT was not si gnificant. Curative tumor resection of stage III disease in combinatio n with IORT (n = 9) resulted in significantly longer survival as compa red with curative tumor resection alone (n = 8) (p < 0.05). It may be advisable to administer IORT in combination with EBRT to patients with advanced pancreatic carcinoma, avoiding aggressive tumor resection, w hen curative tumor resection cannot be performed.