OBJECTIVE: To determine the morbidity and mortality of pancreaticoduodenectomy followed by electron-beam intraoperative radiation therapy (EB-IORT). SUMMARY BACKGROUND DATA: Local recurrence following pancreaticoduodenectomy occurs in 50% to 90% of patients who undergo a potentially curative surgical resection for adenocarcinoma of the pancreatic head. To improve local disease control, a more aggressive retroperitoneal dissection has been combined with adjuvant EB-IORT. METHODS: Forty-one patients with malignant neoplasms of the periampullary region underwent pancreaticoduodenectomy followed by EB-IORT between January 1989 and May 1992. EB-IORT was delivered in a dedicated operative suite, eliminating the need for patient relocation. Electron-beam energies of 6 to 12 MeV were used to deliver 10 to 20 Gy to the treatment field following resection but before pancreatic, biliary, and gastrointestinal reconstruction. RESULTS: Median operative time was 9 hours, blood loss was 1 L, perioperative transfusion requirement was 2 units, and hospital stay was 20 days. One patient died of a postoperative myocardial infarction, and four patients required reoperation, one for an anastomotic leak. No patient failed to receive EB-IORT because of operative complications during the time period of this study. CONCLUSION: Adjuvant EB-IORT after pancreaticoduodenectomy can be delivered safely, with low mortality and acceptable morbidity.
OBJECTIVE: To determine the morbidity and mortality of pancreaticoduodenectomy followed by electron-beam intraoperative radiation therapy (EB-IORT). SUMMARY BACKGROUND DATA: Local recurrence following pancreaticoduodenectomy occurs in 50% to 90% of patients who undergo a potentially curative surgical resection for adenocarcinoma of the pancreatic head. To improve local disease control, a more aggressive retroperitoneal dissection has been combined with adjuvant EB-IORT. METHODS: Forty-one patients with malignant neoplasms of the periampullary region underwent pancreaticoduodenectomy followed by EB-IORT between January 1989 and May 1992. EB-IORT was delivered in a dedicated operative suite, eliminating the need for patient relocation. Electron-beam energies of 6 to 12 MeV were used to deliver 10 to 20 Gy to the treatment field following resection but before pancreatic, biliary, and gastrointestinal reconstruction. RESULTS: Median operative time was 9 hours, blood loss was 1 L, perioperative transfusion requirement was 2 units, and hospital stay was 20 days. One patient died of a postoperative myocardial infarction, and four patients required reoperation, one for an anastomotic leak. No patient failed to receive EB-IORT because of operative complications during the time period of this study. CONCLUSION: Adjuvant EB-IORT after pancreaticoduodenectomy can be delivered safely, with low mortality and acceptable morbidity.
Authors: K R Hogstrom; A L Boyer; A S Shiu; T G Ochran; S M Kirsner; F Krispel; T Rich Journal: Int J Radiat Oncol Biol Phys Date: 1990-05 Impact factor: 7.038
Authors: A M Lowy; J E Lee; P W Pisters; B S Davidson; C J Fenoglio; P Stanford; R Jinnah; D B Evans Journal: Ann Surg Date: 1997-11 Impact factor: 12.969
Authors: R J Bold; K R Hess; A S Pearson; A M Grau; F A Sinicrope; M Jennings; D J McConkey; C D Bucana; K R Cleary; P A Hallin; P J Chiao; J L Abbruzzese; D B Evans Journal: J Gastrointest Surg Date: 1999 May-Jun Impact factor: 3.452
Authors: R J Bold; C Charnsangavej; K R Cleary; M Jennings; A Madray; S D Leach; J L Abbruzzese; P W Pisters; J E Lee; D B Evans Journal: J Gastrointest Surg Date: 1999 May-Jun Impact factor: 3.452
Authors: G M Fuhrman; S D Leach; C A Staley; J C Cusack; C Charnsangavej; K R Cleary; A K El-Naggar; C J Fenoglio; J E Lee; D B Evans Journal: Ann Surg Date: 1996-02 Impact factor: 12.969
Authors: C J Yeo; J L Cameron; K D Lillemoe; J V Sitzmann; R H Hruban; S N Goodman; W C Dooley; J Coleman; H A Pitt Journal: Ann Surg Date: 1995-06 Impact factor: 12.969