Intraoperative irradiation for unresectable pancreatic carcinoma

Twelve patients with localized unresectable, pancreatic carcinoma were treated with a combination of external photon beam and intraoperative electron beam irradiation. Eleven tumors arose in the head and one in the body of the pancreas. Chemotherapy was administered to six of the 12 patients. Of the 11 patients who received both intraoperative and external beam irradiation, four are alive without evident disease. The median survival is 15+ months. This pilot study demonstrates the feasibility of combining external beam and intraoperative therapy in a general hospital setting with no operative deaths, a brief postoperative stay, and no wound infections. The late complications of irradiating gastric antrum and duodenum are discussed.