Intraoperative radiation therapy for patients with pancreatic carcinoma

Abstract

The results of treatment with intraoperative and external beam radiation for patients with carcinoma of the pancreas are presented. Among patients treated with125I implants for localized unresectable disease, local control rates ranged from 67% to 93% and median survival ranged from 7 to 12 months. In a series using intraoperative electron beam boosts, a 59% local control rate with a median survival of 16 months was achieved. Good palliation rates were achieved, although a high proportion of fatal complications occurred in one125I series. Less promising results were seen in patients receiving intraoperative radiation following resections, with a local control rate of 50% and a median survival of 7 months in a series of 10 patients.

Rat liver tolerance for partial resection and intraoperative radiation therapy: Regeneration is radiation dose dependent

“…Intraoperative radiation doses of 20, 30, and 40 Gy were selected for evaluation because these are dose ranges which could be considered for clinical treatment. Currently, doses up to [25][26][27][28][29][30] Gy are the maximum being utilized in the United States for various tumor sites, such as pancreas or stomach.…”

“…Intraoperative radiation therapy has been used with increasing frequency for the treatment of human malignancies [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Unfortunately, there is little information in the literature about the response of hepatic parenchyma to a single large intraoperative radiation dose combined with partial liver resection [ 331,…”

Erfahrungen mit der intraoperativen Radiotherapie beim inoperablen Pankreaskarzinom

“…Erst mit der Einführung von Hochvoltgeräten und Linearbeschleunigern sowie dem Einsatz der computerisierten Bestrahlungsplanung auf Basis von Computertomographie querschnitten ist es erstmals möglich geworden -unter Scho nung umliegender Organe -höhere Dosen an tief gelegene Tumorvolumina heranzubringen [1,2], Trotzdem sind beim Pankreaskarzinom adäquate (meist mehr als 70 Gy) und sicher applizierbare Dosen (perkutan bis 50 Gy) auf externem Wege alleine nicht zu erreichen [15]. Dieses Ziel kann entweder durch die intraoperative Elektronenbestrahlung oder die Implantation radioaktiver Substanzen in das Pankreas in Form einer Zusatzdosis (als «Boost») zur perkutanen Bestrahlung erreicht werden [2,7,16,17]. Über unsere bisherigen Erfahrungen mit der intraoperativen Radiotherapie des inoperablen Pankreaskarzinoms möchten wir im Verlauf dieser Arbeit berichten.…”

Whole liver intraoperative irradiation after partial hepatectomy produces minimal functional and pathologic lesions

“…Intraoperative radiation therapy (IORT) enables the delivery of a large single dose precisely localized to the area(s) of interest and minimizes normal tissue irradiation [19][20][21][22][23][24][25][26]. This may be a potentially useful treatment combined with surgery and/or chemotherapy.…”

“…Considering that only modest improvements in survival (at the cost of considerable risk of complications) have been reported with aggressive systemic or regional chemotherapy [15-181, it might seem logical either in metastatic or primary tumors to employ local hepatic irradiation as an adjuvant to surgery. Intraoperative radiation therapy (IORT) enables the delivery of a large single dose precisely localized to the area(s) of interest and minimizes normal tissue irradiation [19][20][21][22][23][24][25][26]. This may be a potentially useful treatment combined with surgery and/or chemotherapy.…”