Portal de Periódicos da CAPES

Intraoperative Radiation Therapy Following Pancreaticoduodenectomy

1993; Lippincott Williams & Wilkins; Volume: 218; Issue: 1 Linguagem: Inglês

10.1097/00000658-199307000-00009

1528-1140

Douglas B. Evans, Paula M. Termuhlen, David R. Byrd, Frederick C. Ames, Timothy G. Ochran, Tyvin A. Rich,

Cholangiocarcinoma and Gallbladder Cancer Studies

Objective To determine the morbidity and mortality of pancreaticoduodenectomy followed by electron-beam intraoperative radiation therapy (EB-IORT). Summary Background Data Local recurrence following pancreaticoduodenectomy occurs in 50% to 90% of patients who undergo a potentially curative surgical resection for adenocarcinoma of the pancreatic head. To improve local disease control, a more aggressive retroperitoneal dissection has been combined with adjuvant EB-IORT. Methods Forty-one patients with malignant neoplasms of the periampullary region underwent pancreaticoduodenectomy folowed by EB-IORT between January 1989 and May 1992. EB-IORT was delivered in a dedicated operative suite, eliminating the need for patient relocation. Electron-beam energies of 6 to 12 MeV were used to deliver 10 to 20 Gy to the treatment field following resection but before pancreatic, biliary, and gastrointestinal reconstruction. Results Median operative time was 9 hours, blood loss was 1 L, perioperative transfusion requirment was 2 units, and hospital stay was 20 days. One patient died of a postoperative myocardial infarction, and four patients required reoperation, one for an anastomotic leak. No patient failed to receive EB-IORT because of operative complications during the time period of this study. Conclusion Adjuvant EB-IORT after pancreaticoduodenectomy can be delivered safely, with low mortality and acceptable morbidity.