Heijmans H J, Mehta D M, Kleibeuker J H, Sluiter W J, Oldhoff J, Hoekstra H J
Department of Surgical Oncology, Groningen University Hospital, The Netherlands.
Radiother Oncol. 1993 Dec;29(3):347-51. doi: 10.1016/0167-8140(93)90155-2.
Intraoperative electron beam radiotherapy (IORT) is clinically used as a potential adjunctive treatment to surgery of locally advanced pancreatic and gastric cancer. The tolerance of the pancreas to IORT was studied in 15 adult beagles, divided in 3 groups of 5 beagles in which 25, 30 or 35 Gy IORT was delivered through a 6-7 cm circular lucite cone with 6-8 MeV electrons to the pancreas and medial wall of the duodenum. The dogs were followed for endocrine and exocrine pancreatic insufficiency. Two dogs (13%) developed radiation-induced morbidity which consisted of a common bile duct stenosis and an enterocolic fistula, as was confirmed at autopsy after 8 and 18 months, respectively. After a follow-up of 1 year, none of the dogs had developed pancreatitis, diabetes or exocrine insufficiency. There was a significant reduction in serum insulin levels and glucose clearance rates without overt diabetes for 30 Gy and 35 Gy (p < 0.05). No significant changes were found for 25 Gy. This study suggests that 25 Gy IORT to the pancreas may be used clinically, and that higher IORT doses may induce endocrine pancreatic insufficiency in the long-term.
术中电子束放射治疗（IORT）在临床上被用作局部晚期胰腺癌和胃癌手术的一种潜在辅助治疗方法。对15只成年比格犬的胰腺对IORT的耐受性进行了研究，将其分为3组，每组5只比格犬，通过一个6 - 7厘米的圆形有机玻璃锥体，用6 - 8兆电子伏的电子向胰腺和十二指肠内侧壁给予25、30或35戈瑞的IORT。对这些犬进行随访，观察胰腺内分泌和外分泌功能不全情况。两只犬（13%）出现了放射诱发的病症，分别为胆总管狭窄和小肠结肠瘘，在8个月和18个月后尸检得到证实。随访1年后，没有犬发生胰腺炎、糖尿病或外分泌功能不全。对于30戈瑞和35戈瑞剂量，血清胰岛素水平和葡萄糖清除率显著降低，但未出现明显糖尿病（p < 0.05）。25戈瑞剂量未发现显著变化。本研究表明，对胰腺给予25戈瑞的IORT可在临床上应用，而更高剂量的IORT长期可能会诱发胰腺内分泌功能不全。
