Intraoperative radiotherapy for unresectable pancreatic cancer: A multi-institutional retrospective analysis of 144 patients

Kazuhiko Ogawa, Katsuyuki Karasawa, Yoshinori Ito, Yoshihiro Ogawa, Keiichi Jingu, Hiroshi Onishi, Shinichi Aoki, Hitoshi Wada, Masaki Kokubo, Etsuyo Ogo, Hidehiro Etoh, Tomoko Kazumoto, Makoto Takayama, Kenji Nemoto, Yasumasa Nishimura

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18 Citations (Scopus)


Purpose: To retrospectively analyze the results of intraoperative radiotherapy (IORT) + external beam radiotherapy (EBRT) for unresectable pancreatic cancer. Methods and Materials: The records of 144 patients treated with IORT, with or without, EBRT were reviewed. One hundred and thirteen patients (78.5%) were treated with IORT + EBRT and 114 patients (79.2%) were treated in conjunction with chemotherapy. The median doses of IORT and EBRT were 25 Gy and 45 Gy, respectively. The median follow-up of all 144 patients was 9.6 months (range, 0.5-69.7 months). Results: At the time of this analysis, 131 of 144 patients (91.0%) had disease recurrences. Local progression was observed in 60 patients (41.7%), and the 2-year local control (LC) rate in all patients was 44.6%. Patients treated with IORT, with or without, EBRT had significantly more favorable LC (2-year LC, 50.9%) than those treated with IORT without EBRT (p = 0.0004). The 2-year overall survival (OS) rate and the median survival time in all 144 patients were 14.7% and 10.5 months, respectively. Patients treated with chemotherapy had a significantly favorable OS than those treated without chemotherapy (p < 0.0001). On univariate analysis, chemotherapy use alone had a significant impact on OS and on multivariate analysis; chemotherapy use was a significant prognostic factor. Late gastrointestinal morbidity of National Cancer Institute-Common Terminology Criteria Grade 3 was observed in 2 patients (1.4%). Conclusion: IORT + EBRT yields a relatively favorable LC rate for unresectable pancreatic cancer with low frequency of severe late toxicity, and IORT combined with chemotherapy conferred a survival benefit compared with IORT without chemotherapy.

Original languageEnglish
Pages (from-to)111-118
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number1
Publication statusPublished - 2011 May 1


  • IORT
  • Intraoperative
  • Pancreatic neoplasms
  • Radiotherapy
  • Unresectable


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