Treatment strategy for pancreatic head cancer: Pylorus-preserving pancreatoduodenectomy, intraoperative radiotherapy and portal catheterization

Pancreatic cancer is the disease of gastrointestinal cancer with the poores t prognosis. At present, in addition to surgery, multimodality treatment co mbining a variety of therapeutic methods is used. We usually employ the fol lowing combination of surgery, radiotherapy and chemotherapy: D2 surgery wi th pylorus-preserving pancreatoduodenectomy (PPPD), intraoperative radiothe rapy (IORT), and portal catheterization (PC) with fluorouracil as the chemo therapy. in this study, we made a historical comparison of PPPD and PD and obtained the following findings: (1) PPPD allows almost the same extent of D2 dissection as conventional PD, and achieves radical treatment without an y problems; (2) suppression of local recurrence by IORT cannot be expected from the results of the comparison between the four approaches, i.e, surger y alone, surgery + IORT, surgery + PC and surgery + IORT + PC, and (3) the rate of liver metastasis in patients treated by PC was significantly low.