Local management of pancreatic carcinoma: iodine-125 implantation

A retrospective review of patients with pancreatic carcinoma treated from 1983 to 1986 was performed. Group 1 comprise 11 patients judged surgically unresectable who were implanted with iodine-125 followed by external beam therapy post-operatively (Implant + XRT). Eight patients received external beam therapy alone (XRT) Group 2, and 23 patients underwent radical surgical resection (group 3). Median survival was 8 months in the implant + XRT group; 5 months in the XRT alone group and 7.5 months in the surgical group. Locoregional control was achieved in 8/11 (73%), 2/8 (25%), and 11/23 (48%) of these groups respectively. Pain was the most common presenting symptom, 38/42 (90%). Complete, lasting palliation was achieved in 8/10 (80%) of group one, 2/8 (25%) of group two, and 13/20 (65%) of group three patients. Despite surgical unresectability implant + XRT appears to offer similar results to radical surgery. The data are presented with respect to the implant technique, disappearance of the tumour on CT scan and patterns of failure.