[Intraoperative radiotherapy of cancer of the pancreas]

Intra-operative irradiation could overcome some of the problems of conventional "external" radiotherapy, allowing an increase of the tumor dose and better sparing of the normal tissues. The present study reports 14 cases of patients treated by such a technique; 8 cases were pancreatic cancers (only one being surgically removed). The first conventional surgical step was performed in the operating room. The patient, still under general anaesthesia, was then taken to the irradiation room. A linear accelerator (Saturne CGR 20) was utilized to deliver 15-20 Gy to the tumor volume. Three weeks later, the patients received a 40 Gy complementary irradiation by external beams, and 5 Fluorouracil. There were no early post-operative complications. Three patients suffered from painful lesions; pain disappeared in all 3 cases after the intra-operative irradiation. All patients (with the exception of one who was still alive 9 months later) died 4-10 months after treatment. No definitive conclusion can be drawn from this limited case study. However, encouraging results reported by other groups should lead to further studies regarding this possibly promising procedure.