Aggressive local treatment containing intraoperative radiation therapy IORT for patients with isolated local recurrences of pancreatic cancer: a retrospective analysisReportar como inadecuado




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BMC Cancer

, 12:295

First Online: 18 July 2012Received: 03 April 2012Accepted: 18 July 2012DOI: 10.1186-1471-2407-12-295

Cite this article as: Roeder, F., Timke, C., Uhl, M. et al. BMC Cancer 2012 12: 295. doi:10.1186-1471-2407-12-295

Abstract

BackgroundTo evaluate the use of intraoperative radiation therapy IORT in the multimodality treatment of patients with isolated local recurrences of pancreatic cancer.

MethodsWe retrospectively analyzed 36 patients with isolated local recurrences of pancreatic cancer who have been treated with a combination of surgery, IORT and EBRT. Median time from initial treatment to recurrence was 20 months. All patients were surgically explored. In 18 patients a gross total resection was achieved, whereas the other half received only debulking or no resection at all. All patients received IORT with a median dose of 15 Gy. Additional EBRT was applied to 31 patients with a median dose of 45 Gy, combined with concurrent, mainly gemcitabine-based chemotherapy.

ResultsMedian follow-up in surviving patients was 23 months. Local progression was found in 6 patients after a median time of 17 months, resulting in estimated 1- and 2-year local control rates of 91% and 67%, respectively. Distant failure was observed in 23 patients, mainly in liver or peritoneal space. The median estimated progression-free survival was 9 months with 1- and 2-year rates of 40% and 26%, respectively. We found an encouraging estimated median overall survival of 19 months, transferring into 1- and 2-year rates of 66% and 45%. Notably 6 of 36 patients 17% lived for more than 3 years. Severe postoperative complications were found in 3 and chemoradiation-related grade III toxicity in 6 patients. No severe IORT related toxicity was observed.

ConclusionCombination of surgery, IORT and EBRT in patients with isolated local recurrences of pancreatic cancer resulted in encouraging local control and overall survival in our cohort with acceptable toxicity. Our approach seems to be superior to palliative chemotherapy or chemoradiation alone and should be further investigated in a prospective setting specifically addressing isolated local recurrences of pancreatic cancer.

KeywordsPancreatic cancer Isolated local recurrence IORT Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-12-295 contains supplementary material, which is available to authorized users.

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Autor: Falk Roeder - Carmen Timke - Matthias Uhl - Gregor Habl - Frank W Hensley - Markus W Buechler - Robert Krempien - Peter 

Fuente: https://link.springer.com/







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