High dose, external beam and intraoperative radiotherapy in the treatment of resectable and unresectable pancreatic cancer

Shibamoto, Yuta; Manabe, Tadao; Baba, Nobuo; Sasai, Keisuke; Takahashi, Masaji; Tobe, Takayoshi; Abe, Mitsuyuki

doi:10.1016/0360-3016(90)90486-4

Cited by 58 publications

(33 citation statements)

References 22 publications

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“…After palliative surgery, median survival time is only 3-7 months (Brennan et al, 1989;De Rooij et al, 1991). Median survival time for patients with locally irresectable pancreatic carcinoma reported in radiooncological literature, using varying therapy schedules for radiochemotherapy, ranges from 7.5 to 16.5 months (Tepper et al, 1987(Tepper et al, , 1991Wagener et al, 1989;Seydel et al, 1990;Shibamoto et al, 1990;Boz et al, 1991;Jeekel et al, 1991;Montemaggi et al, 1991;Ardalan et al, 1994;Whittington et al, 1995; Table 3). …”

Section: Discussionmentioning

confidence: 99%

Combined modality treatment with accelerated radiotherapy and chemotherapy in patients with locally advanced inoperable carcinoma of the pancreas: results of a feasibility study

Prott

Schönekaes²,

Preusser³

et al. 1997

Br J Cancer

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Summary Between July 1990 and September 1993, 32 patients with locally advanced irresectable adenocarcinoma of the pancreas, histologically proven by laparotomy, were involved in our study. Patients were treated with hyperfractionated, accelerated radiotherapy and simultaneous application of 5-fluorouracil and folinic acid. Chemotherapy was given on days 1,2 and 3. Determination of the target volume for radiotherapy was carried out by computerized axial tomography. The total tumour dose of 44.8 Gy was applied relative to the 90% isodose in two daily fractions of 1.6 Gy, resulting in ten fractions per week. On the first three days of radiotherapy, 600 mg m-of 5-fluorouracil and 300 mg m-3 of folinic acid were given i.v. According to response, chemotherapy was repeated in 4-week intervals. The median survival time for all patients was 12.7 months, compared with 3-7 months after palliative surgery (historical control). The median progression-free interval was 6.6 months. Toxicity and therapy-induced morbidity were recorded according to WHO criteria. Nausea and vomiting of WHO grade and 11 occurred in 72.1% and of grade IlIl and IV in 27.9% of the patients. WHO grade and 11 diarrhoea was seen in 11 patients. The overall incidence of leucopenia and thrombocytopenia was 37.4%; severe side-effects (WHO III-IV) occurred in 9.3% of all patients. One patient experienced a severe mucositis (WHO 1II). This combined modality treatment consisting of accelerated hyperfractionated radiotherapy and chemotherapy turned out to be feasible for patients with locally advanced, irresectable pancreatic cancer. The therapy could be applied in a short period of time, approximately half the time used in conventional therapy schemes.

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Section: Discussionmentioning

confidence: 99%

Combined modality treatment with accelerated radiotherapy and chemotherapy in patients with locally advanced inoperable carcinoma of the pancreas: results of a feasibility study

Prott

Schönekaes²,

Preusser³

et al. 1997

Br J Cancer

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“…20 The median survival for patients in the current study was similar to that achieved with radiotherapy alone (range, 6 -8 months). 1,2,29,32 Furthermore, the addition of cisplatin to 5-FU-based chemoradiotherapy did not appear to improve survival. 33 These results suggest that little or no advantage in patient survival is obtained with the administration of cisplatin, although cisplatin has the potential for radiosensitization and synergism with 5-FU.…”

Section: Discussionmentioning

confidence: 99%

Lack of effectiveness of radiotherapy combined with cisplatin in patients with locally advanced pancreatic carcinoma

Okusaka¹,

Okada²,

Tokuuye

et al. 2001

Cancer

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“…Seit der Einführung der IORT in den 60er Jahren in Japan und den 1970er Jahren in den USA wurde diese Behandlungsform insbesondere bei Malignomen im kleinen Becken sowie bei intraabdominellen und intrazerebralen Neoplasien eingesetzt [1,9,11,34,36]. Obwohl in Hinblick auf Remissionsraten und Palliation gute Ergebnisse erzielt wurden, wurde diese Therapiemodalität beim Mammakarzinom erst etwa 20 Jahre später angewandt (s.u.…”

Section: Introductionunclassified

“…Dabei ist neben dem chirurgischen Vorgehen die Strahlentherapie bei der brusterhaltenden Therapie Hauptgegenstand der Meinungsverschiedenheiten. In diesem Zusammenhang wird einem möglichen Einsatz einer intraoperativen Strahlentherapie (IORT) bei der brusterhaltenden Therapie des Mammakarzinoms vermehrt Aufmerksamkeit geschenkt.Seit der Einführung der IORT in den 60er Jahren in Japan und den 1970er Jahren in den USA wurde diese Behandlungsform insbesondere bei Malignomen im kleinen Becken sowie bei intraabdominellen und intrazerebralen Neoplasien eingesetzt [1,9,11,34,36]. Obwohl in Hinblick auf Remissionsraten und Palliation gute Ergebnisse erzielt wurden, wurde diese Therapiemodalität beim Mammakarzinom erst etwa 20 Jahre später angewandt (s.u.…”

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Intraoperative Strahlentherapie (IORT) in der Behandlung des Mammakarzinoms – eine neue therapeutische Alternative im Rahmen der brusterhaltenden Therapie? Stellenwert und Zukunftsperspektiven. Erfahrungsbericht aus dem European Institute of Oncology (EIO), Mailand

et al. 2001

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Since the applicator can be safely placed under the control of the surgeon and radiotherapist IORT has the potential of accurately treating the tumor bed. Skin and subcutaneous tissue are not irradiated thus decreasing the potential risk of fibrosis and eventually obtaining a better cosmesis. With IORT single doses of 22 Gy being equivalent to a 60 Gy EBRT can safely be delivered. Even so the average time of operation was prolonged by around 20 minutes IORT application ultimately improves the quality of life of the patients in shortening overall treatment. Long-term follow-up is necessary to demonstrate whether large single doses of IORT might have the potential of sufficient local tumor control without major side effects. As a future perspective a randomized trial comparing EBRT with IORT as sole treatment will be performed.

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High dose, external beam and intraoperative radiotherapy in the treatment of resectable and unresectable pancreatic cancer

Cited by 58 publications

References 22 publications

Combined modality treatment with accelerated radiotherapy and chemotherapy in patients with locally advanced inoperable carcinoma of the pancreas: results of a feasibility study

Combined modality treatment with accelerated radiotherapy and chemotherapy in patients with locally advanced inoperable carcinoma of the pancreas: results of a feasibility study

Lack of effectiveness of radiotherapy combined with cisplatin in patients with locally advanced pancreatic carcinoma

Intraoperative Strahlentherapie (IORT) in der Behandlung des Mammakarzinoms – eine neue therapeutische Alternative im Rahmen der brusterhaltenden Therapie? Stellenwert und Zukunftsperspektiven. Erfahrungsbericht aus dem European Institute of Oncology (EIO), Mailand

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