Nakano Kenji, Chijiiwa Kazuo, Toyonaga Takayuki, Ueda Junji, Takamatsu Yuji, Kimura Masahiko, Nakamura Katsumasa, Yamaguchi Koji, Tanaka Masao
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Hepatogastroenterology. 2003 Jul-Aug;50(52):928-33.
BACKGROUND/AIMS: To investigate the therapeutic efficacy of intraoperative radiation for carcinomas of the bile duct and ampulla of Vater.
Postoperative morbidity, mortality and survival of patients undergoing surgical resection of ampullary cancer (n = 19) and bile duct cancer (n = 28) were retrospectively compared between two groups with and without intraoperative radiation.
Background items (age, gender, preoperative laboratory data, operative time and bleeding volume, tumor stage) did not differ significantly between the two groups. The predominant postoperative complication was leakage of pancreatic juice, which occurred in similar rates in both groups. No significant differences were noted in the 3-year survival rates between the resection plus intraoperative radiation group and resection alone group (60.0% (n = 5) vs. 50.1% (n = 13) for ampullary cancer; 0% (n = 4) vs. 27.1% (n = 24) for bile duct cancer, respectively). The main causes of recurrence were distant metastasis for ampullary cancer and microscopic residue of carcinoma for bile duct cancer.
The combination of intraoperative radiation and resection may add no significant benefit to patients with ampullary and bile duct cancer when compared with resection alone.
背景/目的：探讨术中放疗对胆管癌和壶腹癌的治疗效果。
回顾性比较19例壶腹癌和28例胆管癌患者在接受手术切除时，术中放疗组与未进行术中放疗组的术后发病率、死亡率及生存率。
两组患者的背景资料（年龄、性别、术前实验室检查数据、手术时间、出血量、肿瘤分期）无显著差异。术后主要并发症为胰液漏，两组发生率相似。壶腹癌切除加术中放疗组与单纯切除组的3年生存率无显著差异（分别为60.0%（n = 5）对50.1%（n = 13））；胆管癌分别为0%（n = 4）对27.1%（n = 24）。壶腹癌复发的主要原因是远处转移，胆管癌是癌组织镜下残留。
与单纯切除相比，术中放疗联合切除对壶腹癌和胆管癌患者可能无显著益处。
