Lacaine F, Schlienger M, Houry S, Huguier M
Service de chirurgie digestive, hôpital Tenon, Paris, France.
Bull Cancer. 1990;77(3):289-94.
Intra-operative irradiation could overcome some of the problems of conventional "external" radiotherapy, allowing an increase of the tumor dose and better sparing of the normal tissues. The present study reports 14 cases of patients treated by such a technique; 8 cases were pancreatic cancers (only one being surgically removed). The first conventional surgical step was performed in the operating room. The patient, still under general anaesthesia, was then taken to the irradiation room. A linear accelerator (Saturne CGR 20) was utilized to deliver 15-20 Gy to the tumor volume. Three weeks later, the patients received a 40 Gy complementary irradiation by external beams, and 5 Fluorouracil. There were no early post-operative complications. Three patients suffered from painful lesions; pain disappeared in all 3 cases after the intra-operative irradiation. All patients (with the exception of one who was still alive 9 months later) died 4-10 months after treatment. No definitive conclusion can be drawn from this limited case study. However, encouraging results reported by other groups should lead to further studies regarding this possibly promising procedure.
术中放疗可以克服传统“外照射”放疗的一些问题，能提高肿瘤剂量并更好地保护正常组织。本研究报告了14例采用该技术治疗的患者；其中8例为胰腺癌（仅1例接受了手术切除）。首先在手术室进行常规手术步骤。患者仍处于全身麻醉状态，随后被送至放疗室。使用直线加速器（Saturne CGR 20）对肿瘤体积给予15 - 20 Gy的剂量。三周后，患者接受40 Gy的外照射及5 - 氟尿嘧啶辅助放疗。术后无早期并发症。3例患者出现疼痛性病变；术中放疗后所有3例疼痛均消失。所有患者（除1例9个月后仍存活外）在治疗后4 - 10个月死亡。从这个有限的病例研究中无法得出明确结论。然而，其他研究小组报告的令人鼓舞的结果应促使对这种可能有前景的治疗方法进行进一步研究。
