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Title: Intraoperative Radiotherapy for Pancreatic Cancer: 30-Year Experience in a Single Institution in Japan

Abstract

Purpose: To analyze retrospectively the results of intraoperative radiotherapy (IORT) with or without external beam radiotherapy ({+-} EBRT) for localized pancreatic cancer in the past three decades and to analyze prognostic factors by multivariate analysis. Methods and Materials: Records for 322 patients with pancreatic cancer treated by IORT {+-} EBRT in Tohoku University Hospital between 1980 and 2009 were reviewed. One hundred ninety-two patients who had no distant organ metastases or dissemination at the time of laparotomy were enrolled in the present study. Results: Eighty-three patients underwent gross total resection (R0: 48 patients, R1: 35 patients), and 109 patients underwent only biopsy or palliative resection. Fifty-five patients underwent adjuvant EBRT, and 124 underwent adjuvant chemotherapy. The median doses of IORT and EBRT were 25 and 40 Gy, respectively. The median follow-up period was 37.5 months. At the time of the analysis, 166 patients had disease recurrence, and 35 patients had local failure. The 2-year local control (LC) and overall survival (OS) rates were 71.0% and 16.9%, respectively. Comparison of the results for each decade showed that OS was significantly improved decade by decade (2-year: 25.0% vs. 18.8% vs. 4.2%, p < 0.001). Multivariate analysis showed that degree of resection (R0-1more » vs. R2, hazard ratio = 1.97, p = 0.001) and adjuvant chemotherapy (yes vs. no, hazard ratio = 1.54, p = 0.028) had significant impacts on OS. Late gastrointestinal morbidity of Common Terminology Criteria for Adverse Events version 3.0 grade 4 or 5 was observed in four patients. Conclusion: Excellent local control for pancreatic cancer with few cases of severe late toxicity was achieved by using IORT. OS of patients with pancreatic cancer treated by IORT {+-} EBRT improved significantly decade by decade. Multivariate analysis showed that degree of resection and adjuvant chemotherapy had significant impacts on OS.« less

Authors:
 [1];  [1];  [2]; ; ; ; ; ; ; ; ; ;  [1]
  1. Department of Radiation Oncology, Tohoku University School of Medicine, Sendai (Japan)
  2. Department of Radiation Oncology, Yamagata University School of Medicine, Yamagata (Japan)
Publication Date:
OSTI Identifier:
22058951
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 83; Journal Issue: 4; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOPSY; CHEMOTHERAPY; COMBINED THERAPY; DISEASE INCIDENCE; DOSES; FAILURES; HAZARDS; METASTASES; MULTIVARIATE ANALYSIS; NEOPLASMS; PANCREAS; PATIENTS; RADIOTHERAPY; TOXICITY

Citation Formats

Jingu, Keiichi, Tanabe, Takaya, Nemoto, Kenji, Ariga, Hisanori, Umezawa, Rei, Ogawa, Yoshihiro, Takeda, Ken, Koto, Masashi, Sugawara, Toshiyuki, Kubozono, Masaki, Shimizu, Eiji, Abe, Keiko, and Yamada, Shogo. Intraoperative Radiotherapy for Pancreatic Cancer: 30-Year Experience in a Single Institution in Japan. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2012.01.024.
Jingu, Keiichi, Tanabe, Takaya, Nemoto, Kenji, Ariga, Hisanori, Umezawa, Rei, Ogawa, Yoshihiro, Takeda, Ken, Koto, Masashi, Sugawara, Toshiyuki, Kubozono, Masaki, Shimizu, Eiji, Abe, Keiko, & Yamada, Shogo. Intraoperative Radiotherapy for Pancreatic Cancer: 30-Year Experience in a Single Institution in Japan. United States. https://doi.org/10.1016/J.IJROBP.2012.01.024
Jingu, Keiichi, Tanabe, Takaya, Nemoto, Kenji, Ariga, Hisanori, Umezawa, Rei, Ogawa, Yoshihiro, Takeda, Ken, Koto, Masashi, Sugawara, Toshiyuki, Kubozono, Masaki, Shimizu, Eiji, Abe, Keiko, and Yamada, Shogo. 2012. "Intraoperative Radiotherapy for Pancreatic Cancer: 30-Year Experience in a Single Institution in Japan". United States. https://doi.org/10.1016/J.IJROBP.2012.01.024.
@article{osti_22058951,
title = {Intraoperative Radiotherapy for Pancreatic Cancer: 30-Year Experience in a Single Institution in Japan},
author = {Jingu, Keiichi and Tanabe, Takaya and Nemoto, Kenji and Ariga, Hisanori and Umezawa, Rei and Ogawa, Yoshihiro and Takeda, Ken and Koto, Masashi and Sugawara, Toshiyuki and Kubozono, Masaki and Shimizu, Eiji and Abe, Keiko and Yamada, Shogo},
abstractNote = {Purpose: To analyze retrospectively the results of intraoperative radiotherapy (IORT) with or without external beam radiotherapy ({+-} EBRT) for localized pancreatic cancer in the past three decades and to analyze prognostic factors by multivariate analysis. Methods and Materials: Records for 322 patients with pancreatic cancer treated by IORT {+-} EBRT in Tohoku University Hospital between 1980 and 2009 were reviewed. One hundred ninety-two patients who had no distant organ metastases or dissemination at the time of laparotomy were enrolled in the present study. Results: Eighty-three patients underwent gross total resection (R0: 48 patients, R1: 35 patients), and 109 patients underwent only biopsy or palliative resection. Fifty-five patients underwent adjuvant EBRT, and 124 underwent adjuvant chemotherapy. The median doses of IORT and EBRT were 25 and 40 Gy, respectively. The median follow-up period was 37.5 months. At the time of the analysis, 166 patients had disease recurrence, and 35 patients had local failure. The 2-year local control (LC) and overall survival (OS) rates were 71.0% and 16.9%, respectively. Comparison of the results for each decade showed that OS was significantly improved decade by decade (2-year: 25.0% vs. 18.8% vs. 4.2%, p < 0.001). Multivariate analysis showed that degree of resection (R0-1 vs. R2, hazard ratio = 1.97, p = 0.001) and adjuvant chemotherapy (yes vs. no, hazard ratio = 1.54, p = 0.028) had significant impacts on OS. Late gastrointestinal morbidity of Common Terminology Criteria for Adverse Events version 3.0 grade 4 or 5 was observed in four patients. Conclusion: Excellent local control for pancreatic cancer with few cases of severe late toxicity was achieved by using IORT. OS of patients with pancreatic cancer treated by IORT {+-} EBRT improved significantly decade by decade. Multivariate analysis showed that degree of resection and adjuvant chemotherapy had significant impacts on OS.},
doi = {10.1016/J.IJROBP.2012.01.024},
url = {https://www.osti.gov/biblio/22058951}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 83,
place = {United States},
year = {Sun Jul 15 00:00:00 EDT 2012},
month = {Sun Jul 15 00:00:00 EDT 2012}
}