Hosotani R, Kogire M, Arii S, Nishimura Y, Hiraoka M, Imamura M
First Department of Surgery, Kyoto University, Japan.
Hepatogastroenterology. 1997 Nov-Dec;44(18):1528-35.
BACKGROUND/AIMS: Surgical resection provides the only chance for long-term survival for adenocarcinoma of the pancreas. However, a major problem of surgery appears to be post-resection recurrence. The purpose of the current study was to evaluate the efficacy of intraoperative radiotherapy (IORT) and/or external beam radiotherapy (EBRT) in combination with resective surgery.
86 patients received radiotherapy combined with resection surgery and 64 patients received surgery alone. Of 86 patients, 37 received postoperative EBRT, 14 received IORT, and 31 received both. The primary outcome variable analyzed was survival.
The survival curve in patients who received radiotherapy combined with resective surgery was significantly better than that in patients who only received surgery (MST: 12.8 vs. 7.9 months). The number of patients in both groups was equally populated on the basis of potentially prognostic factors such as gender and age of patients, type of resection, vascular resection, location of the tumor, and pTNM classification. Among the subgroups of the patients, adjuvant radiotherapy showed significant survival benefit in the patient group with pT3 tumor, pN positive and R0 surgery.
Adjuvant radiotherapy including TORT with resection surgery for adenocarcinoma of the pancreas is accomplished with acceptable risk and provides significant survival benefit.
