Early experience with intraoperative radiotherapy in patients with resected pancreatic adenocarcinoma

Messick, Craig; Hardacre, Jeffrey M.; McGee, Michael F.; Siegel, Christopher T.; Stellato, Thomas A.; Sanabria, Juan R.; Kinsella, Timothy J.; Schulak, James A.

doi:10.1016/j.amjsurg.2007.12.024

« Previous Next »The American Journal of Surgery
Volume 195, Issue 3 , Pages 308-312, March 2008

Early experience with intraoperative radiotherapy in patients with resected pancreatic adenocarcinoma

Craig Messick, M.D.
- Department of Surgery, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106-5047, USA
Jeffrey M. Hardacre, M.D.
- Department of Surgery, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106-5047, USA
- Corresponding author. Tel.: +1-216-844-7047; fax: +1-216-844-2888.
Michael F. McGee, M.D.
- Department of Surgery, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106-5047, USA
Christopher T. Siegel, M.D., Ph.D.
- Department of Surgery, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106-5047, USA
Thomas A. Stellato, M.D.
- Department of Surgery, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106-5047, USA
Juan R. Sanabria, M.D.
- Department of Surgery, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106-5047, USA
Timothy J. Kinsella, M.D.
- Department of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
James A. Schulak, M.D.
- Department of Surgery, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106-5047, USA

Received 13 December 2007; received in revised form 13 December 2007 published online 21 January 2008.

Abstract

Background

The use of intraoperative radiotherapy (IORT) in patients with resected pancreatic adenocarcinoma has not been clearly defined.

Methods

The medical records of our first 22 patients receiving IORT for resected pancreatic adenocarcinoma (2001 to 2006) were reviewed and compared with the records of 27 consecutive patients not receiving IORT for resected pancreatic adenocarcinoma (2004 to 2006).

Results

There were no 30-day mortalities in either group, and complication rates were similar. Local recurrence occurred in 18% in the IORT group (median 14 months) and 12% in the no-IORT group (median 7 months). Distant recurrence occurred in 47% in the IORT group (median 11 months) and 32% in the no-IORT group (median 6.5 months). Median overall, stage-specific, and location-specific survival did not differ between the groups.

Conclusions

Although limited in size and follow-up, our experience showed that complications, recurrence, and survival were not affected by IORT, but time to recurrence may be longer with IORT.

Keywords: Intraoperative radiotherapy, Pancreatic cancer