Houry S, Mariani P, Schlienger M, Huguier M
Service de Chirurgie digestive, Hôpital Tenon, Paris.
Ann Chir. 1996;50(6):438-44.
The aim of this study was to evaluate intraoperative radiotherapy in exocrine pancreatic cancer (n = 10) and in recurrent colorectal carcinoma (n = 11). Radiotherapy was delivered with electron beams (energy from 9 MeV to 20 MeV). Doses ranged from 15 Gy to 25 Gy. All patients with pancreatic cancer also received 40 Gy external beam irradiation and 5-Fluorouracil (500 mg/m2) and eight patients with recurrent colorectal carcinoma received postoperative external beam irradiation (20 Gy to 60 Gy). There were no postoperative deaths or complication. In pancreatic cancers, pain relief (7 cases) until death was observed in all cases. After palliative procedures (9 cases), the median survival time was 6 months (ranging from 4 months to 14 months). One patient is alive with a follow-up of 5 years and 6 months following total pancreatectomy. 5 patients with recurrent colorectal carcinoma, died with a median survival time of 13 months (ranging from 2 months to 25 months), and six patients are alive. Two of them have recurrence, and four are free of recurrence with a mean follow-up of 21 months (ranging from 3 months to 54 months). In conclusion, our results for pancreatic cancer agree with the disappointing results reported by other institutions. On the other hand, recurrence of colorectal carcinoma seems to be a good indication for intra-operative radiotherapy even when resection is incomplete.
本研究旨在评估术中放疗在外分泌型胰腺癌(n = 10)和复发性结直肠癌(n = 11)中的应用。放疗采用电子束(能量为9 MeV至20 MeV)。剂量范围为15 Gy至25 Gy。所有胰腺癌患者还接受了40 Gy的外照射和5-氟尿嘧啶(500 mg/m²),8例复发性结直肠癌患者接受了术后外照射(20 Gy至60 Gy)。术后无死亡或并发症发生。在胰腺癌患者中,所有病例均观察到直至死亡时疼痛缓解(7例)。姑息治疗(9例)后,中位生存时间为6个月(4个月至14个月)。1例患者在全胰切除术后随访5年6个月仍存活。5例复发性结直肠癌患者死亡,中位生存时间为13个月(2个月至25个月),6例患者存活。其中2例复发,4例无复发,平均随访21个月(3个月至54个月)。总之,我们关于胰腺癌的结果与其他机构报告的令人失望的结果一致。另一方面,即使切除不完全,结直肠癌复发似乎也是术中放疗的一个良好适应证。