Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Sep;95(38):e4861.
doi: 10.1097/MD.0000000000004861.

Long-term results of intraoperative electron beam radiation therapy for nonmetastatic locally advanced pancreatic cancer: Retrospective cohort study, 7-year experience with 247 patients at the National Cancer Center in China

Yingtai Chen  1 , Xu Che, Jianwei Zhang, Huang Huang, Dongbing Zhao, Yantao Tian, Yexiong Li, Qinfu Feng, Zhihui Zhang, Qinglong Jiang, Shuisheng Zhang, Xiaolong Tang, Xianghui Huang, Yunmian Chu, Jianghu Zhang, Yuemin Sun, Yawei Zhang, Chengfeng Wang
Affiliations

Long-term results of intraoperative electron beam radiation therapy for nonmetastatic locally advanced pancreatic cancer: Retrospective cohort study, 7-year experience with 247 patients at the National Cancer Center in China

Yingtai Chen et al. Medicine (Baltimore). 2016 Sep.

Abstract

To assess prognostic benefits of intraoperative electron beam radiation therapy (IOERT) in patients with nonmetastatic locally advanced pancreatic cancer (LAPC) and evaluate optimal adjuvant treatment after IOERT.A retrospective cohort study using prospectively collected data was conducted at the Cancer Hospital of the Chinese Academy of Medical Sciences, China National Cancer Center.Two hundred forty-seven consecutive patients with nonmetastatic LAPC who underwent IOERT between January 2008 and May 2015 were identified and included in the study. Overall survival (OS) was calculated from the day of IOERT. Prognostic factors were examined using Cox proportional hazards models. The 1-, 2-, and 3-year actuarial survival rates were 40%, 14%, and 7.2%, respectively, with a median OS of 9.0 months. On multivariate analysis, an IOERT applicator diameter < 6 cm (hazards ratio [HR], 0.67; 95% confidence interval [CI], 0.47-0.97), no intraoperative interstitial sustained-release 5-fluorouracil chemotherapy (HR, 0.46; 95% CI, 0.32-0.66), and receipt of postoperative chemoradiotherapy followed by chemotherapy (HR, 0.11; 95% CI, 0.04-0.25) were significantly associated with improved OS. Pain relief after IOERT was achieved in 111 of the 117 patients, with complete remission in 74 and partial remission in 37. Postoperative complications rate and mortality were 14.0% and 0.4%, respectively. Nonmetastatic LAPC patients with smaller size tumors could achieve positive long-term survival outcomes with a treatment strategy incorporating IOERT and postoperative adjuvant treatment.Chemoradiotherapy followed by chemotherapy might be a recommended adjuvant treatment strategy for well-selected cases. Intraoperative interstitial sustained-release 5-fluorouracil chemotherapy should not be recommended for patients with nonmetastatic LAPC.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Overall survival is shown among patients with nonmetastatic LAPC who were treated with IOERT (n = 217).
Figure 2
Figure 2
Overall survival according to adjuvant treatment modality (n = 197).
See this image and copyright information in PMC

References

    1. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin 2009; 59:225–249. - PubMed
    1. Huguet F, Goodman KA, Azria D, et al. Radiotherapy technical considerations in the management of locally advanced pancreatic cancer: American-French consensus recommendations. Int J Radiat Oncol Biol Phys 2012; 83:1355–1364. - PubMed
    1. Royal RE, Wolff RA, Crane CH. De Vita VTJ, Lawrence TS, Rosenberg SA. Cancer of the pancreas. Principles and Practice of Oncology 8th ed.Philadelphia: Lippincott Williams & Wilkins; 2008. 1086–1123.
    1. Huguet F, Girard N, Guerche CS, et al. Chemoradiotherapy in the management of locally advanced pancreatic carcinoma: a qualitative systematic review. J Clin Oncol 2009; 27:2269–2277. - PubMed
    1. Ishikawa H, Suzuki Y, Nakayama Y, et al. Intraoperative radiotherapy and bypass surgery for unresectable pancreatic cancer. Hepatogastroenterology 2000; 47:1151–1155. - PubMed

Publication types

MeSH terms