Intra-operative radiotherapy (IORT) in pancreatic cancer: joint analysis of the ISIORT-Europe experience

Autor: Gian Carlo Mattiucci, Valerio Di Carlo, Giuseppe D'Agostino, Michele Reni, Markus W. Büchler, Alessio G. Morganti, J.L. Garcia-Sabrido, Felix Sedlmayer, Gerd Fastner, Falk Roeder, Giovanni Battista Doglietto, Vincenzo Valentini, Robert Krempien, Felipe A. Calvo, Paolo Passoni
Přispěvatelé: Valentini, V, Calvo, F, Reni, M, Krempien, R, Sedlmayer, F, Buchler, Mw, Di Carlo, V, Doglietto, Gb, Fastner, G, Garcia-Sabrido, Jl, Mattiucci, G, Morganti, Ag, Passoni, P, Roeder, F, D'Agostino, Gr, Valentini, Vincenzo, Calvo, Felipe, Reni, Michele, Krempien, Robert, Sedlmayer, Felix, Buchler, Markus W., Carlo, Valerio Di, Doglietto, Giovanni B., Fastner, Gerd, Garcia-Sabrido, José L., Mattiucci, Giancarlo, Morganti, Alessio G., Passoni, Paolo, Roeder, Falk, D'Agostino, Giuseppe R
Rok vydání: 2008
Předmět:
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 91(1)
ISSN: 0167-8140
Popis: Purpose: A joint analysis of data from five contributing centers within the ISIORT-Europe program was performed to investigate the main contributions of intra-operative radiotherapy (IORT) to the multidisciplinary treatment of pancreatic cancer. Materials and methods: Patients with a histologic diagnosis of carcinoma of the pancreas, with an absence of distant metastases, undergoing surgery with radical intent and IORT were considered eligible for participation in this study. Results: From 1985 to 2006, a total of 270 patients were enrolled in the study from five European Institutions. Surgery was performed in 91.5% of cases and complicated by adverse events in 59 cases. External radiotherapy (ERT) preceded surgery in 23.9% of cases. One-hundred and six patients received further ERT. After surgery + IORT, median follow-up was 96 months (range 3-180). Median local control was 15 months, 5-year local control was 23.3%. Median overall survival was 19 months, while 5-year survival was 17.7%. A significantly greater local control and survival were observed in patients undergoing preoperative radiotherapy (LC: median not reached; OS: median 30 months) compared to patients treated with postoperative ERT alone (LC: median 28 months; OS: median 22 months), and to patients submitted to IORT exclusively (LC: median 8 months; OS: median 13 months) (p < 0.0001). Conclusion: From this joint analysis emerges the fact that preoperative radiotherapy increases the effects of IORT in terms of local control and overall survival. The 5-year local control of 23.3% confirms the beneficial "sterilizing" effect of IORT on the tumor bed. (C) 2008 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 91 (2009) 54-59
Databáze: OpenAIRE