J.Jpn. Surg. Soc.. 83(9): 1069-1072, 1982

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Report on the annual meeting

INTRAOPERATIVE IRRADIATION COMBINED WITH RADICAL RESECTION FOR CANCER OF THE HEAD OF THE PANCREAS

In our clinic since December 1976, an intraoperative irradiation combined with radical resection has been introduced; after pancreatoduodenectomy, 3,000 rad. of the electron beam from a linear accelator were administered to the operative field including the celiac axis and mesenteric radix. The intraoperative combined therapy was performed on 11 patients with cancer of the head of the pancreas. Fifteen patients underwent merely pancreatoduodenectomy.
In the patients with pancreatic cancer undergone the combined therapy, cumulative survival rate improved slightly, but survival time of those patients did not exceed 2 years. A good effect of the combined therapy on cumulative survival rate was not obtained comparing to the pancreatoduodenectomy group.
Autopsy of 3 cases undergone the combined therapy did not revealed involvement of the lymph nodes around the celiac axis and mesenteric radix, however, it revealed involvement of the lymphnodes around the abdominal aorta out the irradiation area and metastases to the liver in all cases and recurrence of remnant pancreas in one case. Autopsy of 4 cases undergone pancreatoduodenectomy revealed involvement of the lymphnodes around the celiac axis and mesenteric radix in all cases, metastases to the liver in 3 cases and recurrence of remnant pancreas in one case.
These results suggest that anticancer treatment for cancer of the pancreatic head should be intensified toward involvement of the lymphnodes around abdominal aorta and spread to the liver in addition to our intraoperative combined therapy and total pancreatectomy should be indicated to the case with multiple lesions in the pancreas.

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