Intraoperative radiation therapy following pancreaticoduodenectomy

D. B. Evans, P. M. Termuhlen, D. R. Byrd, F. C. Ames, T. G. Ochran, T. A. Rich

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

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 followed 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 requirement 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.

Original languageEnglish (US)
Pages (from-to)54-60
Number of pages7
JournalAnnals of surgery
Volume218
Issue number1
DOIs
StatePublished - Jan 1 1993

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Pancreaticoduodenectomy
Radiotherapy
Electrons
Morbidity
Anastomotic Leak
Mortality
Operative Time
Reoperation
Dissection
Length of Stay
Adenocarcinoma
Myocardial Infarction
Recurrence

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Intraoperative radiation therapy following pancreaticoduodenectomy. / Evans, D. B.; Termuhlen, P. M.; Byrd, D. R.; Ames, F. C.; Ochran, T. G.; Rich, T. A.

In: Annals of surgery, Vol. 218, No. 1, 01.01.1993, p. 54-60.

Research output: Contribution to journalArticle

Evans, D. B. ; Termuhlen, P. M. ; Byrd, D. R. ; Ames, F. C. ; Ochran, T. G. ; Rich, T. A. / Intraoperative radiation therapy following pancreaticoduodenectomy. In: Annals of surgery. 1993 ; Vol. 218, No. 1. pp. 54-60.
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N2 - 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 followed 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 requirement 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.

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