External radiotherapy for unresectable carcinoma of the pancreas

From September 1987 through June 1992, 20 patients with unresectable pancreatic carcinoma were treated with irradiation. Their ages ranged from 52 to 83 years, with a mean of 66. All 20 patients received a dose of 35 to 45 Gy by twice-a-day irradiation schedule. After then, conformation irradiation with a scheduled total dose of 65 to 70 Gy were given to 14 patients, two of whom was switched to twice-a-day irradiation because of their severe side effects. In 20 patients, mean survival time was 197 days in patients without liver metastasis, and 150 days in patients with liver metastasis. Pain relief was attained in 19 patients (75%). CT revealed complete response or complete tumor disappearance in 5 patients. All of the 5 patients was, however, found to have viable cells on autopsy. Currently available combined treatment of irradiation and chemotherapy may be of limited value in the local control of unresectable pancreatic carcinoma. (N.K.)