Zur Bedeutung der IORT in der Therapie des Pankreaskarzinoms

At the time of diagnosis, pancreatic carcinoma in most cases presents as a inoperable disease or with metastatic spread and can thus not be treated with curative intent. The aim is to analyze the role of intraoperative radiotherapy (IORT) in those patients. Methods and Materials: From 1989 - 1996, we performed a total of 49 intraoperative irradiations for pancreatic adenocarcinoma. In 20 cases, histology showed no residual tumor, whereas in 29 cases, it was not possible to remove the tumor completely. In nearly than half of the cases (23/49), metastasis was already present at the time of surgery. Complete local resection was possible in four of the M1 cases and in 16/49 patients without metastasis. IORT was performed at an non-dedicated linear accelerator, with electron energy and field size depending on target-volume and tissue depth.The median dose was 20 Gy. Postoperative radio- or chemotherapy were not performed. Results: The overall median survival was 6,0 months for all 49 patients, 9,4 months after complete local resection in M0 patients and 6,5 months in M1 patients. After incomplete resection, median survival was 3,4 months in M0 and 3,5 months in M1 patients. Conclusions: This study shows the importance of complete local tumor remission on survival even in primarily metastatic disease. In this context, IORT is a helpful tool to improve local radicality. Due to the worse prognosis of patients with adenocarcinoma of the pancreas, new combined treatment modalities as adjuvant and neoadjuvant radio-chemotherapy for patients with resectable and unresectable tumors are under investigation. For some reasons, the adjuvant setting seems to be better. However, these results are not proven by prospective randomized clinical trials. Therefore, these trials are necessary to define the treatment of choice in those patients.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2001

Author dc:creator

• Frangen, Thomas Manfred

Contributors dc:contributor

• Eble, Michael J.

• info:eu-repo/classification/ddc/610
• Medizin

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-118958%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A56881