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Medline ® Abstract for Reference 133

of 'Initial chemotherapy and radiation for nonmetastatic, locally advanced, unresectable and borderline resectable, exocrine pancreatic cancer'

133
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Effect on local control and survival of electron beam intraoperative irradiation for resectable pancreatic adenocarcinoma.
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Reni M, Panucci MG, Ferreri AJ, Balzano G, Passoni P, Cattaneo GM, Cordio S, Scaglietti U, Zerbi A, Ceresoli GL, Fiorino C, Calandrino R, Staudacher C, Villa E, Di Carlo V
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Int J Radiat Oncol Biol Phys. 2001;50(3):651.
 
PURPOSE: To assess the impact on local control and survival of intraoperative radiotherapy (IORT) in resectable pancreatic adenocarcinoma.
METHODS AND MATERIALS: The outcome of 127 patients surgically treated with curative intent combined with IORT was compared with the therapeutic results of 76 patients treated with surgery as exclusive treatment.
RESULTS: Operative mortality and morbidity were similar in IORT and no-IORT patients. In 49 patients with locally limited disease (Stage I-II; LLD), IORT (n = 30) reduced the local failure rate and significantly prolonged time to local failure (TTLF), time to failure (TTF), and overall survival (OS) with respect to surgery alone (n = 19). The multivariate analyses, stratifying patients by age, tumor grade, resection margins, chemotherapy, and external-beam radiotherapy use, confirmed the independent impact of IORT on outcome. In patients with locally advanced disease (Stage III-IVA; LAD), IORT had an impact on localfailure rate and on TTLF when combined with beam energies of greater than 6 MeV, whereas no effect on TTF and OS was observed.
CONCLUSION: IORT did not increase operative mortality and morbidity and achieved a significant improvement in local control and outcome in patients with LLD. In patients with LAD, beam energies greater than 6 MeV prolonged TTLF.
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Department of Radiochemotherapy, San Raffaele H. Scientific Institute, Milan, Italy. reni.michele@hsr.it
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