Treatment of primary unresectable carcinoma of the pancreas with I-125 implantation Journal Article
| Authors: | Peretz, T.; Nori, D.; Hilaris, B.; Manolatos, S.; Linares, L.; Harrison, L.; Anderson, L. L.; Fuks, Z.; Brennan, M. F. |
| Article Title: | Treatment of primary unresectable carcinoma of the pancreas with I-125 implantation |
| Abstract: | Between January 1 1974 and October 31 1987, 98 patients with biopsy proven unresectable adenocarcinoma of the pancreas were treated with I-125 implants during laparotomy. Presenting symptoms were pain (57 patients), jaundice (45 patients), and weight loss (34 patients). All patients underwent laparotomy and surgical staging. Thirty patients had TINoMo disease, 47 patients had T2-3NoMo disease, and 21 patients had significant regional lymph node involvement (Tl-3N1Mo). The surgical procedure performed was biopsy only (16 patients), gastric bypass (36 patients), biliary bypass (49 patients), and partial or total pancreatectomy with incomplete resection (5 patients). The total activity and the number of seeds used were determined from the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram. Stereoshift localization X ray films were taken 3-6 days after operation. The mean activity, minimal peripheral dose (MPD), and volume of the implants were 35 mCi, 13,660 cGy, and 53 cm3, respectively. In addition, 27 patients received postoperative external irradiation and 27 patients received chemotherapy. Postoperative complications were observed in 19 patients. These included post-operative death (1 patient), biliary fistula (4), intruabdominal abscess (4), GI bleeding (3), gastric or small bowel obstruction (6), sepsis (5), and deep vein thrombophlebitis (4). Pain relief was obtained in 37 57 patients (65%) presenting with pain. A multivariate analysis showed that four factors significantly affected survival: T stage, N stage, administration of chemotherapy, and more than 30% reduction in the size of the implant on follow-up films. The median survival for the entire group was 7 months. A subgroup of patients with TINo stage disease who received chemotherapy survived 18.5 months. The indications for I-125 seed implantation in unresectable carcinoma of the pancreas are discussed. © 1989. |
| Keywords: | adolescent; adult; aged; major clinical study; fluorouracil; pancreatic neoplasms; cancer staging; laparotomy; adenocarcinoma; histology; pancreas carcinoma; iodine 125; iodine radioisotopes; brachytherapy; radioisotope; radioisotope therapy; middle age; i-125 implantation; prognosis; human; male; female; priority journal; adenocarcinoma of the pancreas |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 17 |
| Issue: | 5 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1989-11-01 |
| Start Page: | 931 |
| End Page: | 935 |
| Language: | English |
| DOI: | 10.1016/0360-3016(89)90138-7 |
| PUBMED: | 2808054 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 14 April 2020 -- Source: Scopus |
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