Carcinoma of the pancreas: results of irradiation for unresectable lesions

From 1973 to 1977, 20 patients who had histologically proven unresectable adenocarcinoma of the pancreas with no distant metastases were irradiated at the Medical College of Wisconsin Affiliated Hospitals. The patients received megavoltage external irradiation to minimum tumor doses ranging between 3000 rod in 4 weeks and 5700 rod in 7 weeks (median 4600 rod in 6 weeks their actuarial survival was 54% at 12 months and 21% at 24 months.Fourteen patients who received 4500 rod or more in 6–7 weeks had a median survival of 13 months. Six patients received less than 4500 rod in 3–6 weeks, and their median survival was 7 months. At this writing, three patients are alive and apparently disease free more than 2 years after treatment.Complications were seen in two patients. One died from GI bleeding 2 months after completion of radiation therapy, and the other patient developed pancreatic insufficiency.These results and recent reports in the literature show that aggressive irradiation can result in long-term disease free survival in a small proportion of patients with unresectable pancreatic adenocarcinoma. Further exploitation of this approach alone or combined with chemotherapy is warranted.