ABSTRACT
INTRODUCTION: The application of intraoperative radiation therapy to the tumor bed after resection of pancreatic cancer has been shown to be beneficial in the local control of the disease. The objective of this study was to evaluate the preliminary outcomes after the application of a single intraoperative dose to the tumor bed with a new intraoperative radiotherapy device (Intrabeam®) in terms of viability, safety and short-term results. METHODS: We studied 5 patients who underwent pancreaticoduodenectomy for resectable pancreatic cancer in which a radiotherapy boost (5Gy) was intraoperatively applied to the tumoral bed using the portable Intrabeam® device, a low-energy point-source X-ray. Postoperative complications, hospital stay and mortality, recurrences and short-term survival were analyzed. RESULTS: Mean patient age was 68 years. All patients had a T3-stage tumor and one of them N1. In 3 patients, R0 resection was performed, while R1 resection was conducted in 2. Perioperative mortality was 0%. The only complications included delayed gastric emptying and postoperative hemorrhage. There were no pancreatic fistulas. During follow-up (mean: 11.2 months), there was a relapse in the patient who had undergone R1 resection. CONCLUSIONS: The application of radiotherapy with the Intrabeam® device in selected patients has not resulted in increased perioperative morbidity or mortality; therefore, this is a safe procedure for the treatment of resectable cancer.
Subject(s)
Adenocarcinoma/radiotherapy , Adenocarcinoma/surgery , Pancreatic Neoplasms/radiotherapy , Pancreatic Neoplasms/surgery , Pancreaticoduodenectomy , Aged , Combined Modality Therapy , Equipment Design , Female , Humans , Intraoperative Period , Male , Middle Aged , Radiotherapy/instrumentationABSTRACT
INTRODUCCIÓN: La aplicación de radioterapia intraoperatoria en el lecho tumoral tras la resección de un cáncer de páncreas ha demostrado ser beneficiosa en el control local de la enfermedad. El objetivo de este estudio fue valorar los resultados iniciales obtenidos tras la aplicación de una nueva modalidad de radioterapia intraoperatoria (Intrabeam(R)) en términos de viabilidad, seguridad y resultados a corto plazo. MÉTODOS: Se estudiaron 5 pacientes sometidos a duodenopancreatectomía cefálica por cáncer de páncreas resecable, en los que se aplicó intraoperatoriamente un boost de radioterapia (5Gy) en el lecho tumoral mediante la utilización del dispositivo portátil Intrabeam(R), fuente puntual de rayos X de baja energía. Se analizaron las complicaciones, estancia y mortalidad postoperatorias, recidivas y superviviencia a corto plazo. RESULTADOS: La edad media fue de 68 años. Todos los pacientes presentaban un estadio tumoral T3 y uno de ellos N1. En 3 pacientes se realizó una resección R0 y en 2 casos resultó ser una resección R1. La mortalidad peroperatoria fue del 0%. Solo se presentaron como complicaciones un retraso en el vaciamiento gástrico y una hemorragia postoperatoria. No hubo fístulas pancreáticas. Durante el seguimiento (media: 11,2 meses) se constató una recidiva en el paciente en el que se había practicado una resección R1. CONCLUSIONES: La aplicación de radioterapia con el dispositivo Intrabeam(R) en pacientes seleccionados no ha supuesto un aumento de la morbimortalidad peroperatoria, mostrándose como un procedimiento seguro en el tratamiento del cáncer resecable
INTRODUCTION: The application of intraoperative radiation therapy to the tumor bed after resection of pancreatic cancer has been shown to be beneficial in the local control of the disease. The objective of this study was to evaluate the preliminary outcomes after the application of a single intraoperative dose to the tumor bed with a new intraoperative radiotherapy device (Intrabeam(R)) in terms of viability, safety and short-term results. METHODS: We studied 5 patients who underwent pancreaticoduodenectomy for resectable pancreatic cancer in which a radiotherapy boost (5Gy) was intraoperatively applied to the tumoral bed using the portable Intrabeam(R) device, a low-energy point-source X-ray. Postoperative complications, hospital stay and mortality, recurrences and short-term survival were analyzed. RESULTS: Mean patient age was 68 years. All patients had a T3-stage tumor and one of them N1. In 3 patients, R0 resection was performed, while R1 resection was conducted in 2. Perioperative mortality was 0%. The only complications included delayed gastric emptying and postoperative hemorrhage. There were no pancreatic fistulas. During follow-up (mean: 11.2 months), there was a relapse in the patient who had undergone R1 resection. CONCLUSIONS: The application of radiotherapy with the Intrabeam (R) device in selected patients has not resulted in increased perioperative morbidity or mortality; therefore, this is a safe procedure for the treatment of resectable cancer
