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KMID : 0371320020630010051
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Journal of the Korean Surgical Society
2002 Volume.63 No. 1 p.51 ~ p.56
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Effect of Intraoperative Radiation Therapy (IORT) in Unresectable Pancreatic Cancer
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Lee Chun-Hwan
Kim Nam-Ryeol
Kim Chul-Yong
Yang Dae-Sik
Cho Min-Young
Kim Young-Chul
Whang Jeong-Woong
Seo Seong-Ok
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Abstract
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Purpose: Pancreatic cancer is a devastating disease and the complete resection is difficult due to its the aggressive histologic behavior. Among the possible treatments for the unresectable pancreatic cancer, intraoperative radiation
therapy
(IORT) has the several advantages. But the impacts of the IORT on survival and local control are not clear. We analyzed the effects of the IORT on pain control, survival duration and local control in patients with unresectable pancreatic
cancer.
Methods: We reviewed 6 years of the medical records of 94 patients who had undergone operations involving the pancreatic adenocarcinoma (33 patient IORTs, 39 palliative surgerys only and 22 curative resections involving a curative
resection). The
clinicopathologic factors and outcomes of the 33 patients treated with the IORT were compared with those of the palliative surgery groups.
Results: The age and sex distribution and tumor stage were same for the two groups. The average tumor size in the IORT group was larger than those of the palliative surgery group. The preoperative serum CA19-9 level in the IORT group was
higher
than the other group. The most common reason for unresectability in the IORT group was local invasion to the adjacent organs including of the great vessels. On the contrary, distant metastasis was a more common cause unresectability in the
palliative
surgery group. The postoperative complications and operative times were similar in both groups. Pain relief after treatment was observed in 12 cases of the 26 patients in the IORT group, and 5 of 29 patients in the palliative surgery group
(P＜0.05).
The cases of minor and partial remission were more common in the IORT group than the palliative surgery group. However, the survival rate of the IORT group was no better than the palliative surgery group.
Conclusion: This study suggests that IORT may have an important palliative role especially in ameliorating visceral pain in patients with unresectable pancreatic cancer. However, IORT appears to have no significant effect on overall
survival.
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KEYWORD
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