Standard operation combined with intraoperative radiotherapy for pancreatic head cancer

Twenty-six patients with Stage III or IV pancreatic head cancer were treated with standard operation (resection of the pancreatic head and duodenum) combined with intraoperative irradiation. Postoperative hospital stay ranged from 30 to 50 days. Postoperative performance status was 0-2 until cancer recurred. Survival rate was 36% at one year, 8% at 3 years and 8% at 5 years. In patients with comparable stages who did not receive intraoperative irradiation during the same period of time, the corresponding figures at one and 3 years were 18% and 9%, respectively. There was no significant difference between the irradiated and non-irradiated groups. For 9 patients who received intraoperative irradiation for locally advanced stage IV cancer, mean survival time was 259 days. Standard operation comobined with intraoperative irradiation was useful in the management of patients because they did not develop intractable diarrhea. However, it remains to be seen whether intraoperative irradiation may contribute to long-term survival. (N.K.)