Abstract
Five patients with diffuse type of bile duct carcinoma underwent hepato-pancreatoduodenectomy with intraoperative radiation therapy (IORT). IORT was given to the dissected portions, such as the stump of the bile duct or dissected area of the hepatoduodenal ligament where residual tumor cells were revealed histologically at the operation. The policy of adjuvant radiotherapy is to give IORT a safe dose of 1,500 cGy, to prevent adverse side effect, and to add external irradiation for a sufficient tumorcidal dose. One patient survived for 3.3 years and one patient with mucosal spread carcinoma is alive and well for 1.5 years after surgery, however, the effect of this treatment modality was questionable in the other three patients without significant prolongation of the survival time. We are going to continue this approach with more cases for estimating possible effect of TORT.
