The clinical efficacy of intraoperative radiation therapy (IORT) and the changes of immunological parameters were investigated. Nine patients with unresectable pancreatic cancer were treated with IORT (2,500-3,500 cGy) and the changes of various immunological parameters were compared with those in 11 patients with advanced cancer who received external beam irradiation therapy (XRT), 2,500-3,500 cGy. After IORT, 71% of patients obtained pain relief, two of the nine patients showed a partial response, and the serum CA 19-9 level decreased in six patients. However, the median survival was only 210 days. Natural killer activity, lymphokine-activated killer activity, and interferon gamma-activated killer activity were not inhibited by IORT, and phytohemagglutinin-induced blastogenesis was actually augmented after IORT, whereas all these parameters were inhibited by XRT. Thus, it is suggested that IORT may augment or at least stabilize systemic antitumor immunity.
1) During the last 10 years, 11 cases of primary adenosquamous carcinoma of the stomach were operated on. 2) Histologically, the specimens from the stomach showed adenocarcinoma with squamous differentiation in all the cases. 3) All the patients but 1 were males and their average age was 61.2 years. 4) The duration of illness prior to treatment was relatively long period of time and the chief complaints in over half of the patients were abdominal pain. 5) Eight cases showed metastases at the time of operation. Metastasis to the regional lymph nodes was observed in 8 cases and the squamous element was present in 5 of these cases. 6) There was no operative death. Followup study was made in 9 cases. Only 2 are still alive and the remaining 7 died of recurrence. The length of survival averaged 10.7 months.
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