Okamoto A, Tsuruta K, Isawa T, Kamisawa T, Tanaka Y, Onodera T
Department of Surgery, Tokyo Metropolitan Komagome Hospital, Japan.
Int J Pancreatol. 1994 Oct-Dec;16(2-3):157-64. doi: 10.1007/BF02944326.
Ninety patients with carcinoma of the pancreas treated between 1976 and 1990 were reviewed retrospectively. Intraoperative radiation therapy (IORT) in combination with external beam radiation therapy (EBRT) for localized but unresectable tumors (n = 29) prolonged survival significantly more than IORT alone (n = 16) (p < 0.01); it seems EBRT enhanced or contributed to the better results obtained with IORT plus EBRT. Moreover, IORT, alone or in combination, relieved pain. Adjuvant IORT for residual tumors (n = 20) might not effectively prolong survival, because the difference in survival rate between noncurative resection plus IORT and nonresection plus IORT in combination with EBRT was not significant. Curative tumor resection of stage III disease in combination with IORT (n = 9) resulted in significantly longer survival as compared with curative tumor resection alone (n = 8) (p < 0.05). It may be advisable to administer IORT in combination with EBRT to patients with advanced pancreatic carcinoma, avoiding aggressive tumor resection, when curative tumor resection cannot be performed.
对1976年至1990年间接受治疗的90例胰腺癌患者进行了回顾性研究。对于局部但无法切除的肿瘤（n = 29），术中放疗（IORT）联合外照射放疗（EBRT）的生存期显著长于单纯IORT（n = 16）（p < 0.01）；似乎EBRT增强了IORT加EBRT所取得的更好疗效或对其有贡献。此外，IORT单独或联合使用均可缓解疼痛。对残留肿瘤进行辅助IORT（n = 20）可能无法有效延长生存期，因为非根治性切除加IORT与非切除加IORT联合EBRT之间的生存率差异不显著。III期疾病的根治性肿瘤切除联合IORT（n = 9）与单纯根治性肿瘤切除（n = 8）相比，生存期显著延长（p < 0.05）。对于无法进行根治性肿瘤切除的晚期胰腺癌患者，当不能进行积极的肿瘤切除时，联合EBRT给予IORT可能是可取的。
