Cromack D T, Maher M M, Hoekstra H, Kinsella T J, Sindelar W F
Surgery Branche, National Cancer Institute, Bethesda, Md 20892.
Arch Surg. 1989 Feb;124(2):229-34. doi: 10.1001/archsurg.1989.01410020103017.
To evaluate whether intraoperative radiation therapy (IORT) results in higher complication rates than conventional radiotherapy, 119 patients were studied who entered four prospectively randomized clinical trials that compared IORT with conventional therapy. Malignant neoplasms included 33 gastric carcinomas, 35 retroperitoneal sarcomas, 22 resectable pancreatic cancers, and 29 unresectable pancreatic cancers. One hundred thirty-six complications developed among 66 patients who received conventional therapy, and 108 complications developed among 53 patients who received IORT. There was no statistical significance between treatment groups with respect to the overall incidence of complications. Analysis of types of complications by tumor type using Fisher's exact test revealed only one significant complication: an increased rate of sepsis among the patients with retroperitoneal sarcoma who received conventional therapy compared with their IORT cohorts. The overall complication rate associated with IORT was equivalent to conventional radiotherapy in the treatment of these malignant neoplasms and supported the use of IORT where clinically indicated.
为评估术中放射治疗（IORT）是否比传统放射治疗导致更高的并发症发生率，我们对119名患者进行了研究，这些患者参与了四项前瞻性随机临床试验，这些试验比较了IORT与传统治疗。恶性肿瘤包括33例胃癌、35例腹膜后肉瘤、22例可切除胰腺癌和29例不可切除胰腺癌。在接受传统治疗的66例患者中发生了136例并发症，在接受IORT的53例患者中发生了108例并发症。治疗组之间在并发症的总体发生率方面没有统计学意义。使用Fisher精确检验按肿瘤类型分析并发症类型发现只有一种显著的并发症：与接受IORT的队列相比，接受传统治疗的腹膜后肉瘤患者中败血症发生率增加。在这些恶性肿瘤的治疗中，与IORT相关的总体并发症发生率与传统放射治疗相当，并支持在临床指征明确的情况下使用IORT。
