J.Jpn. Surg. Soc.. 83(9): 1065-1068, 1982

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Report on the annual meeting

MULTIMODAL TREATMENT UTILIZING INTRAOPERATIVE RADIOTHERAPY FOR ADVANCED CANCER OF THE PANCREAS

Thirty-three cases of unresectable cancer of the pancreas have been treated by a combination of intraoperative radiotherapy plus by-pass operation and chemotherapy. The stage of the tumor varied from a localized tumor in the pancreas to a huge tumor with multiple metastases. At laparotomy, a high-energy electron beam was directly irradiated to the tumor in a dosage of 3,000 rad using a Betatron. Careful preparation of the tumor was made in order to avoid irradiating the duodenum and other adjacent organs. Choledochojejunostomy and gastrojejunostomy were performed if necessary to overcome obstruction. In some patients external radiation was added in a dosage of 3,000 rad by lineac X-ray. After the radiotherapy, chemotherapy was continued using daily 5-FU or FT207.
The survival time after this therapy was different mainly according to stage of the tumor. In the group, tumor were localized at the pancreas but considered as unresectable mainly because of tumor invasion of the portal vein, among these 14 patients 7 SURVIVED MORE THAN ONEY EAR. This survival were never shorter than that of resected cases. Intraoperative radiotherapy palliated the pain due to cancer of the pancreas.

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