Zaki Azzam Ayman, Alqarni Ahmed, Mahmoud Amin Tarek
General Surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Surgical Oncology Department, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Hepato-biliary Pancreatic Surgery Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
J Egypt Natl Canc Inst. 2018 Jun;30(2):77-79. doi: 10.1016/j.jnci.2018.03.002. Epub 2018 Apr 18.
In spite of the advances in modern surgery, the outcome for patients suffering from pancreatic adenocarcinoma or periampullary adenocarcinoma is still bad. Recently, introperative radiotherapy (IORT) was introduced into the multimodality management approach to improve both tumor control and patient' survival.
To evaluate our initial experience in combined surgical resection and IORT, and to evaluate the feasibility of the application of IORT and its effect on morbidity, mortality and local recurrence.
This study was conducted at King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia. Data were collected retrospectively. A total of six patients were included in the study, during the period from November 2013 to April 2017. All surgeries were done by the same surgeon.
The average age was 60 years (50-71). The patients were four males and two females. Five patients underwent complete surgical resection (pancreaticoduodenectomy) combined with IORT. One patient had locally advanced pancreatic tumor which was beyond surgical resection, for whom surgical bypass was done to overcome the biliary obstruction combined with IORT. Two patients died from disease progression and liver metastases. The remaining four patients survived without any evidence of local recurrence or metastases on follow-up.
Application of IORT is safe and feasible. It can be applied without additional morbidities or mortalities. Although our results are satisfactory, yet they need to be applied on a larger number of patients with longer periods of follow-up to reach sound conclusions.
尽管现代外科手术取得了进展，但胰腺腺癌或壶腹周围腺癌患者的预后仍然很差。最近，术中放疗（IORT）被引入多模式管理方法，以改善肿瘤控制和患者生存率。
评估我们在联合手术切除和IORT方面的初步经验，评估IORT应用的可行性及其对发病率、死亡率和局部复发的影响。
本研究在沙特阿拉伯王国利雅得的法赫德国王专科医院和研究中心进行。数据进行回顾性收集。在2013年11月至2017年4月期间，共有6名患者纳入研究。所有手术均由同一位外科医生完成。
平均年龄为60岁（50 - 71岁）。患者为4名男性和2名女性。5名患者接受了完整的手术切除（胰十二指肠切除术）并联合IORT。1名患者患有局部晚期胰腺癌，无法进行手术切除，为此进行了手术旁路以克服胆道梗阻并联合IORT。2名患者死于疾病进展和肝转移。其余4名患者在随访中存活，无任何局部复发或转移的证据。
IORT的应用是安全可行的。可以在不增加额外发病率或死亡率的情况下应用。尽管我们的结果令人满意，但仍需要在更多患者中应用并进行更长时间的随访，以得出可靠的结论。
