[Studies on treatment results and prognostic factors of intraoperative radiotherapy in pancreatic carcinoma].

Results of intraoperative radiotherapy (IORT) in 70 patients who were treated for pancreatic carcinoma during the recent eleven years are presented. For analysis of treatment results, patients were divided into three groups depending on the treatment period: the initial period ('76.4-'79.12), the mid period ('80.1-'83.3) and the latest period ('83.4-'87.6). Median survival in each period was 4 months, 6 months and 11.5 months, respectively. As for the clinical stage, the median survival of patients with Stage I or II, Stage III and Stage IV were 10.5 months, 8 months and 3 months, respectively. The patient's survival with a combination of tumor resection and postoperative external radiotherapy (ExRT) seemed superior to that of other treatment modalities. As a result of statistical comparison of prognostic factors among each group, it was shown that the treatment period was most significant (p less than 0.01). Besides this, clinical stage, tumor resection and ExRT were significant factors in obtaining long survival. The patient's characteristics, however, were different in each group, so Stage IV was excluded from each group and survival was re-analyzed. As a result, the treatment modality consisting of IORT plus ExRT was found to be the most important prognostic factor. In conclusion, IORT should be applied to patients with pancreatic carcinoma except for Stage IV cases. The dose in IORT ranging from 20Gy to 25Gy combined with the dose in ExRT ranging from 40Gy to 50Gy was considered to contribute to the improvement of prognosis without causing serious side effects.