PANCREATIC RESECTION COMBINED WITH INTRAOPERATIVE RADIATION-THERAPY FOR PANCREATIC-CANCER

Objective The objective of the study was to analyze a single center's experience in the treatment of pancreatic carcinoma with a combination of pancreatic resection and intraoperative radiation therapy (IORT). Summary Background Data Pancreatic cancer is the most lethal form of g astrointestinal malignancy; Historically, it carries a 20% I-year surv ival and a 5-year survival of 3% to 5%. Since 1987, patients at Thomas Jefferson University Hospital have been offered IORT in an attempt to improve their survival. Methods The authors reviewed all patients tre ated at Thomas Jefferson University Hospital with pancreatic adenocarc inoma from 1987 to 1994, From this population, 14 patients were identi fied who received IORT in conjunction with curative surgery. Duration of hospital stay, perioperative complications, duration of postoperati ve ileus, and survival were assessed by retrospective review. Results Of the 14 patients, 6 were male and 8 were female. Patient median age was 61. Six patients had stage I disease, 2 had stage II, 6 had stage III. Two patients had total pancreatectomy, 2 had distal pancreatectom y, and tile remaining had pancreaticoduodenectomy (Whipple resection). Median survival was 16 months with a 15.5% 5-year survival. Postopera tive complications, duration of hospital stay, and duration of postope rative ileus were not adversely affected by the addition of IORT when compared to in-house control subjects. Conclusions Intraoperative radi ation therapy is a useful adjunct to surgical resection as treatment o f pancreatic cancer. The authors' data suggested it can prolong median survival and long-term survival without adding significant morbidity.