aggressive local treatment containing intraoperative radiation therapy (iort) for patients with isolated local recurrences of pancreatic cancer a retrospective analysis当地的积极治疗术中放疗(iort)包含孤立的局部复发的胰腺癌患者进行回顾性分析.pdfVIP

Roeder et al. BMC Cancer 2012, 12:295 /1471-2407/12/295 RESEARCH ARTICLE Open Access Aggressive local treatment containing intraoperative radiation therapy (IORT) for patients with isolated local recurrences of pancreatic cancer: a retrospective analysis 1,2* 1 1 1 1 3 Falk Roeder , Carmen Timke , Matthias Uhl , Gregor Habl , Frank W Hensley , Markus W Buechler , 4 1,2 1,2† 3† Robert Krempien , Peter E Huber , Juergen Debus and Jens Werner Abstract Background: To evaluate the use of intraoperative radiation therapy (IORT) in the multimodality treatment of patients with isolated local recurrences of pancreatic cancer. Methods: We 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. Results: Median 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%, res