Intraoperative radiotherapy for unresectable pancreatic cancer

Between 1984 and 1992, thirteen patients with unresectable pancreatic cancer were treated with intraoperative radiotherapy (IOR). One patient had Stage I disease, and 12 had Stage IV according to the General Rules of the Japan Pancreas Society. Nine of these patients underwent postoperative external beam radiotherapy with doses of 26 to 90 Gy. All of the patients underwent both distal gastrectomy with Billroth-II type reconstruction for gastrointestinal bypass and cholecysto-jejunostomy (Roux-Y) for biliary bypass. No postoperative complications due to either IOR or the bypass operations occurred. Median survival time was 12 months, and 50% survival time was 10 months. The longest survival period was 36 months. Preoperative pain decreased or disappeared. All of the patients were discharged and a few were able to return to work. Intraoperative radiotherapy with bypass surgery is a useful means of improving the quality of life of patients with unresectable pancreatic cancer. (author)