Abstract
In order to study the significance of the intraoperative radiation therapy (IORT), seventy patients who had extended pancreaticoduodenectomy (ExPD) for a carcinoma of the head of the pancreas during 1983 and 1990 were selected for this study.
These patients were compared for postoperative survival and local recurrence with or without IORT at a dose of 25 Gy by grouping as follows.
Grouping A: All 70 patients who had histologically curative or non-curative resection were divided into 16 receiving ExPD+IORT and 54, ExPD only. Grouping B: Fourty-two patients who had histologically curative resection were divided into 12 receiving ExPD+IORT and 30, ExPD only. Grouping C: Twenty-eight patients who had histologically non-curative resection were divided into 4 receiving ExPD+IORT and 24, ExPF only. As a result, the median survival rates in ExPD+IORT and ExPD only patients were 13 months and 13 months in grouping A; 13 months and 14 months in grouping B; and 14 months and 11 months in grouping, C, respectively, where no significant difference was noted. There was also no significant difference in the local recurrence, namely, the incidences of local recurrence in ExPD+IORT and IORT only patients were 75% and 50% in grouping A; 50% and 42% in grouping B; and 100% and 67% in grouping C, respectively.
These results showed that intraoperative radiation therapy at the dose of 25 Gy did not improve the median survival and local recurrence in patients undergoing extended pancreaticodenectomy for the carcinoma of the head of the pancreas.
