Survival after attempted surgical resection and intraoperative radiation therapy for pancreatic and periampullary adenocarcinoma

Journal Article · Tue Nov 15 04:00:00 EST 2005 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2005.03.036· OSTI ID:20706249

O'Connor, John K ^[1]; Sause, William T ^[2]; Hazard, Lisa J ^[3]; Belnap, Legrande P ^[4]; Noyes, R Dirk ^[4]

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1. Department of Radiation Oncology, Tulane Cancer Center, New Orleans, LA (United States)
2. Department of Radiation Oncology, LDS Hospital, Salt Lake City, UT (United States)
3. Department of Radiation Oncology, University of Utah/Hunstman Cancer Institute, Salt Lake City, UT (United States)
4. Department of Surgery, LDS Hospital, Salt Lake City, UT (United States)

Purpose: To evaluate a single institution's experience with intraoperative radiation therapy (IORT) in combination with attempted surgical resection for pancreatic and periampullary adenocarcinoma. Methods and Materials: From May 1986 until June 2001, 77 patients at LDS Hospital underwent attempted surgical resection and IORT for pancreatic or periampullary adenocarcinoma. A potentially curative resection was defined as surgery with negative or microscopic positive margins. No patients had metastatic disease at the time of surgery and IORT. Forty-four patients with tumors located in the pancreas and 9 patients with periampullary tumors underwent potentially curative surgical resection and IORT. Twenty-four patients had pancreatic tumors deemed unresectable and underwent surgical bypass and IORT. Actuarial survival was calculated from the date of IORT until last follow-up or death by use of the Kaplan-Meier method. Results: Patients undergoing a potentially curative resection and IORT for periampullary adenocarcinoma had a median survival of 167 months and a 56% 5-year actuarial survival, compared with a median survival of 16 months and a 19% 5-year actuarial survival for patients undergoing the same treatment for pancreatic adenocarcinoma (p = 0.03). Patients with unresectable disease who underwent bypass and IORT had a median survival of 11 months and a 0% 3-year survival, significantly worse than patients able to undergo surgical resection and IORT (p = 0.0002). The operative mortality for all patients undergoing potentially curative resection and IORT was 3.7%. Conclusions: Intraoperative radiation therapy is well tolerated and does not increase the morbidity or mortality of potentially curative surgical resection for pancreatic or periampullary adenocarcinoma. Patients with periampullary adenocarcinoma have a better prognosis than those with pancreatic adenocarcinoma, and patients with unresectable pancreatic disease fared worse.

• OSTI ID: 20706249
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 63; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BYPASSES
CARCINOMAS
DISEASE INCIDENCE
METASTASES
MORTALITY
PANCREAS
PATIENTS
RADIOTHERAPY
SURGERY