Intraoperative radiotherapy for pancreatic carcinoma with hepatic or peritoneal metastases

The purpose of this study was to determine the efficacy of intraoperative radiotherapy (IORT) for unresectable pancreatic carcinoma associated with hepatic or peritoneal metastasis.

Between 1991 and 1994, 53 patients with pancreatic carcinoma associated with hepatic or peritoneal metastasis underwent surgery. Twenty-four of these patients received IORT, while 29 received no radiation therapy. The efficacy of IORT on the postoperative survival and pain relief for these patients was retrospectively analyzed.

Postoperative survival was lowest in the subgroup of patients (n = 18) with both hepatic and peritoneal metastases, and this group did not benefit from IORT (IORT, n = 6; no IORT, n = 12) in terms of survival. Similarly, there was no significant difference in the survival rates between patients undergoing IORT (n = 10) and patients without IORT (n = 11) in the subgroup of patients with hepatic metastasis but without peritoneal metastasis. However, patients with peritoneal metastasis but without hepatic metastasis benefited significantly from IORT (IORT, n = 8; no IORT, n = 6) (p < 0.05). Pain relief following IORT was observed in 9 out of 10 patients who had experienced pain prior to surgery.

Pancreatic carcinoma associated with peritoneal metastasis but without hepatic metastasis can be palliated by IORT. In addition, pain palliation in patients who require gastrointestinal or biliary drainage can also be achieved by IORT.