X. Che1, Y. Chen1, J. Zhang1, C. Wang1 1Cancer Hospital Chinese Academy Of Medical Sciences,Department Of Abdominal Surgical Oncology,Beijing, BEIJING, China
Introduction: Several studies have shown that intraoperative radiotherapy provides a marginal increase in the survival rate for patients with resectable pancreatic cancer. For locally advanced unresectable pancreatic cancer patients, however, the result was scarce and inconsistent. The aim of present study is to assess the safety and efficacy of intraoperative radiotherapy in unresectable pancreatic cancer.
Methods: From January 2008 to October 2013, 176 cases of locally advanced pancreatic cancer were treated with intraoperative radiotherapy and postoperative concurrent chemoradiotherapy and chemotherapy including 61 T3 cases and 115 T4 cases; maximum diameter of tumor: 3-9cm with an average of 5.1 ± 1.5cm; diameter of applicator for IORT: 4-10cm with an average of 5.9 ± 1.0cm; irradiation intensity:6-15Mev with an average of 11.6 ± 1.1Mev; irradiation dose:1000-2000cGry with an average of 1400 ± 245cGry.
Results:Intraoperative blood loss of intraoperative radiotherapy was 50.5ml in average, postoperative pancreatic fistula was 4%, delayed gastric emptying was 9.9%, and the differences were not statistically significant compared with surgery alone. There was no level 3 or more hematologic toxicity. 49 patients were treated with intraoperative radiotherapy plus postoperative concurrent chemoradiotherapy and chemotherapy: median survival time was 14.7 months and survival rate for 1 year was 65%; rate of pain relief was 72%. As for conventional chemoradiotherapy without intraoperative radiotherapy, median survival time was 11.1 months, survival rate for 1 year was 23% and rate of pain relief was 41%.
Conclusion:In conclusion, intraoperative radiotherapy may be delivered safely and effectively in combination with chemoradiotherapy for patients with locally advanced unresectable pancreatic cancer.