Analysis of intraoperative radiotherapy for pancreatic carcinoma

Intraoperative radiotherapy (IORT) involves the administration of higher doses of irradiation to the pancreas in patients with locally advanced disease, and to the surgical bed in patients following pancreaticoduodenectomy. IORT was initially used in patients with unresectable lesions on whom palliative surgery was being performed. In all the series local control was improved, although no parallel increase in survival has been confirmed. Various institutions have used IORT after pancreatic resection, integrated into a complementary programme of chemo-and radiotherapy. A significant reduction in the index of local recurrence has been documented in all the series. No significant improvement in survival has been documented, owing to the development of metastases.