Adjuvant radiation therapy for pancreatic cancer: A 15-Year experience

• Published in: International journal of radiation oncology, biology, physics Vol. 39; no. 1; pp. 31 - 37
• Main Authors: Dobelbower, Ralph R., Merrick, Hollis W., Khuder, Sadik, Battle, Joyce A., Herron, Lisa M., Pawlicki, Todd
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.1997; Elsevier
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Cause of Death; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Intraoperative radiation therapy; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Pancreatic cancer; Pancreatic Neoplasms - drug therapy; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - radiotherapy; Pancreatic Neoplasms - surgery; Radiation therapy; Radiotherapy, Adjuvant; Retrospective Studies; Survival Analysis; Tumors; Intraoperative radiation therapy; Pancreatic cancer; Radiation therapy; Human; Postoperative; Treatment efficiency; Adjuvant treatment; Intraoperative; Malignant tumor; Radiotherapy; Extracorporeal irradiation; Radical resection; Surgery; Digestive diseases; Pancreas; Survival curve; Comparative study; Pancreatic disease
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/S0360-3016(97)00125-9

Purpose : A retrospective analysis to determine differences in survival of patients with pancreatic adencarcinoma treated by radical surgery with and without adjuvant radiation therapy. Methods and Materials : Between 1980 and 1995, 249 patients with pancreatic tumors were identified at the Medical College of Ohio. Forty-four of these patients underwent radical surgical procedures with curative intent. These patients were divided into four groups according to treatment: surgery alone ( n = 14), surgery plus intraoperative radiation therapy (IORT) ( n = 6), surgery plus external beam radiation therapy (EBRT) ( n = 14), or surgery plus both IORT and EBRT ( n = 10). Outcome and survival were analyzed among the four groups. Results : The median survival time of patients treated with radical surgery alone was 6.5 months. The median survival time for the surgery plust IORT group was 9 months; however, 33.3% (two of six) of these patients survived longer than 5 years. This survival pattern was borderline significantly bettern than that for the surgery alone group ( p = 0.0765). The surgery plus EBRT and the surgery plus IORT and EBRT groups had median survival times of 14.5 and 17.5 months, respectively. These were significantly better than that of the surgery alone group ( p = 0.0004 and p = 0.0002, respectively). The addition of radiation therapy did not affect the treatment complication rate. Conclusion : The survival of patients who were treated with radical surgery alone was significantly poorer than that of patients who received adjuvant radiation therapy. These results are consistent with other studies in the literature. Patients treated with all three modalities (surgery, IORT, and EBRT) displayed the best median survival time.