Effect on local control and survival of electron beam intraoperative irradiation for resectable pancreatic adenocarcinoma

Purpose: To assess the impact on local control and survival of intraoperati ve radiotherapy (IORT) in resectable pancreatic adenocarcinoma. Methods and Materials: The outcome of 127 patients surgically treated with curative intent combined with IORT was compared with the therapeutic result s of 76 patients treated with surgery as exclusive treatment. Results: Operative mortality and morbidity were similar in IORT and no-IORT patients. In 49 patients with locally limited disease (Stage I-II; LLD), I ORT(n = 30) reduced the local failure rate and significantly prolonged time to local failure (TTLF), time to failure (TTF), and overall survival (OS) with respect to surgery alone (n 19), The multivariate analyses, stratifyin g patients by age, tumor grade, resection margins, chemotherapy, and extern al-beam radiotherapy use, confirmed the independent impact of IORT on outco me, In patients with locally advanced disease (Stage III-IVA; LAD), IORT ha d an impact on local failure rate and on TTLF when combined with beam energ ies of greater than 6 MeV, whereas no effect on TTF and OS was observed. Conclusion: IORT did not increase operative mortality and morbidity and ach ieved a significant improvement in local control and outcome in patients wi th LLD. In patients with LAD, beam energies greater than 6 MeV prolonged TT LF, (C) 2001 Elsevier Science Inc.