Intraoperative Radiotherapy for Unresectable Pancreatic Cancer: A Multi-Institutional Retrospective Analysis of 144 Patients
- Department of Radiology, University of the Ryukyus, Okinawa (Japan)
- Department of Radiation Oncology, Tokyo Metropolitan Komagome Hospital, Tokyo (Japan)
- Department of Radiation Oncology, National Cancer Center, Tokyo (Japan)
- Department of Radiation Oncology, Tohoku University, Sendai (Japan)
- Department of Radiology, Yamanashi University, Yamanashi (Japan)
- Department of Radiation Oncology, Yamagata University, Yamagata (Japan)
- Department of Radiation Oncology, Institute of Biomedical Research and Innovation Hospital, Kobe (Japan)
- Department of Radiology, Kurume University, Kurume (Japan)
- Department of Radiation Oncology, Saitama Cancer Center, Saitama (Japan)
- Department of Radiation Oncology, Kyorin University, Tokyo (Japan)
- Department of Radiation Oncology, Kinki University School of Medicine, Osaka (Japan)
Purpose: To retrospectively analyze the results of intraoperative radiotherapy (IORT) + external beam radiotherapy (EBRT) for unresectable pancreatic cancer. Methods and Materials: The records of 144 patients treated with IORT, with or without, EBRT were reviewed. One hundred and thirteen patients (78.5%) were treated with IORT + EBRT and 114 patients (79.2%) were treated in conjunction with chemotherapy. The median doses of IORT and EBRT were 25 Gy and 45 Gy, respectively. The median follow-up of all 144 patients was 9.6 months (range, 0.5-69.7 months). Results: At the time of this analysis, 131 of 144 patients (91.0%) had disease recurrences. Local progression was observed in 60 patients (41.7%), and the 2-year local control (LC) rate in all patients was 44.6%. Patients treated with IORT, with or without, EBRT had significantly more favorable LC (2-year LC, 50.9%) than those treated with IORT without EBRT (p = 0.0004). The 2-year overall survival (OS) rate and the median survival time in all 144 patients were 14.7% and 10.5 months, respectively. Patients treated with chemotherapy had a significantly favorable OS than those treated without chemotherapy (p < 0.0001). On univariate analysis, chemotherapy use alone had a significant impact on OS and on multivariate analysis; chemotherapy use was a significant prognostic factor. Late gastrointestinal morbidity of National Cancer Institute-Common Terminology Criteria Grade 3 was observed in 2 patients (1.4%). Conclusion: IORT + EBRT yields a relatively favorable LC rate for unresectable pancreatic cancer with low frequency of severe late toxicity, and IORT combined with chemotherapy conferred a survival benefit compared with IORT without chemotherapy.
- OSTI ID:
- 21491731
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 80, Issue 1; Other Information: DOI: 10.1016/j.ijrobp.2010.01.065; PII: S0360-3016(10)00268-3; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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