External and intraoperative radiotherapy for resectable and unresectable pancreatic cancer: Analysis of survival rates and complications

Intraoperative and conformal external‐beam radiation therapy with protracted 5‐fluorouracil infusion in patients with locally advanced pancreatic carcinoma

“…9,10 In addition, Mohiuddin et al 13 reported that the MST and 2-year survival rate of combined IORT and perioperative 5-FU chemotherapy were 16 months and 20%, respectively, and that this treatment improved survival. Nishimura et al 14 reported that a combination of IORT and EBRT produced better survival rates than EBRT alone when used to treat patients with unresectable pancreatic carcinoma. However, Roldan et al 11 reported finding no significant difference in median or long-term survival between EBRT alone and a combination of IORT and EBRT (MST, 12.6 months vs. 13.4 months).…”

Does Intraoperative Radiation Therapy Improve Local Tumor Control in Patients Undergoing Pancreaticoduodenectomy for Pancreatic Adenocarcinoma? A Propensity Score Analysis

“…27 Although some authors report a survival benefit from IORT for resectable pancreatic tumors at their institutions, the literature does not consistently support this claim, and detection of a potential small survival benefit would require a large trial. 19,22,24,26,28,29 Regardless of the absence of improved survival, the problem of locoregional control does leave open a place for radiation therapy after PD, and IORT is an effective technique to boost radiation dose around the resection bed while displacing sensitive adjacent organs. 8,10,17,30 A recent analysis of the Surveillance, Epidemiology, and End Results database revealed a survival benefit to the addition of adjuvant radiotherapy after PD, and radiation therapy remains an important component of adjuvant strategies in the United States.…”

Multimodality Approaches for Pancreatic Cancer

“…27,28 Patients with a positive surgical margin after tumor resection have no better overall survival than unresectable patients treated with systemic chemotherapy and localized radiation. 27,29,30 It should be noted that the mortality associated with curative pancreatic cancer surgery in major referral centers is as low as 2% and is inversely proportional to patient volume. [31][32][33] During the initial part of the procedure, there is assessment of tumor resectability, specifically evaluating the major vessels and searching for any metastatic disease.…”