Multidisciplinary treatment for resectable pancreatic cancer

Since November 1983, a multidisciplinary protocol for the treatment of pancreatic carcinoma has been used for eight patients at the National Cancer Center Hospital. This therapy includes an extended pancreatic resection, intra-operative irradiation with 3,000 rad of electrons using a microton, and an intra-operative hepatic arterial or portal infusion of mitomycin C, 10 mg. Furthermore, post-operative chemotherapy with mitomycin C (10 mg to 10 mg x 3) is added by Seldinger's method or intravenously (i.v.). The post-operative course was uneventful in all eight patients. Although the number of patients treated is small, the one-year survival rate was 86%. This rate is markedly better than the 28% after conventional radical pancreatectomy from 1962 to 1983. According to our experience, pancreatic carcinoma is unlikely to be cured by only radical operative procedures. A multidisciplinary treatment protocol as an adjunct to radical surgery appears necessary for a good prognosis of this disease.