Intraoperative Radiation Therapy Combined with Hyperthermia against Pancreatic Carcinoma.

Abstract

Fourteen patients with pancreatic carcinoma were treated by intraoperative radiation therapy (TORT) combined with hyperthermia (hyperthermia group). Their treatment results were compared with those of fifty five patients treated by TORT without hyperthermia (control group). Most of patients underwent some kind of chemotherapy for the carcinoma and some of them received post-operative irradiation. Although there was no significant difference in pain relief between hyperthermia group and control group, the local tumor control rate of the former group was a little better. The survival rate of all patients was 14.5% at one year, 2.9% at two years, 2.9% at three years and 0% at four years after surgery. The survival rate of the hyperthermia group was 21.4% at one year and 7.1% at two years and that of the control group was 12.7% at one year and 1.8% at two years. The survival of the hyperthermia group was a little better than that of control group, but the difference was not significant. Only 36% of patients of hyperthermia group were successfully heated, and if hyperthermia were given successfully to all patients, their prognoses would be possibly improved, pancreatic carcinoma ; intraoperative radiation therapy ; hyperthermia

The clinical benefit of hyperthermia in pancreatic cancer: a systematic review

“…After the first and second selection (Figure 1), 14 studies were included [53][54][55][56][57][58][59][60][61][62][63][64][65][66]. Two patient cohorts were each described in two articles; for these we excluded the oldest [67,68] and included the latest [54,57].…”

“…The included 14 studies combined 395 pancreatic cancer patients of whom 248 received HT (Table 1). Six out of 14 studies used a control population that enabled a comparison between treatments with and without hyperthermia [54,55,57,60,62,66]. In two studies, patients with a variety of carcinomas were included, but data were reported for the pancreatic patients separately [53,59].…”

“…Most of the 395 pancreatic cancer patients had either LAPC (204 patients, 52%) or metastatic disease (175 patients, 44%); in two studies, a total of 16 patients had resectable or borderline resectable pancreatic cancer [54,58], Table 1. Seven studies included both patients with locally advanced and patients with metastatic disease.…”

“…For the patients who received HT within the studies, this HT was in combination with radiotherapy for 17 patients (7%, two studies) [53,55], with chemoradiotherapy for 82 patients (33%, four studies) [54,60,62,66], and with chemotherapy for 149 patients (60%) in the remaining eight studies. Three types of hyperthermia treatment were applied: locoregional, whole-body and intraoperative hyperthermia.…”

Review: The Role of Hyperthermia in Treating Pancreatic Tumors

“…Criticism 20 years ago was regarding the apparent inability to sufficiently generate surface heat [5]. A Greek group published promising data about unresectable palliative cases with a scheme of multi-schedule chemotherapy combined with radiation (45 Gy) plus a single session of hyperthermia during bypass surgery [6].…”