Biomedical subjects
Publications and source records attributed to T Isawa.
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Ninety patients with carcinoma of the pancreas treated between 1976 and 1990 were reviewed retrospectively. Intraoperative radiation therapy (IORT) in combination with external beam radiation therapy (EBRT) for localized but unresectable tumors (n = 29) prolonged survival significantly more than IORT alone (n = 16) (p < 0.01); it seems EBRT enhanced or contributed to the better results obtained with IORT plus EBRT. Moreover, IORT, alone or in combination, relieved pain. Adjuvant IORT for residual tumors (n = 20) might not effectively prolong survival, because the difference in survival rate between noncurative resection plus IORT and nonresection plus IORT in combination with EBRT was not significant. Curative tumor resection of stage III disease in combination with IORT (n = 9) resulted in significantly longer survival as compared with curative tumor resection alone (n = 8) (p < 0.05). It may be advisable to administer IORT in combination with EBRT to patients with advanced pancreatic carcinoma, avoiding aggressive tumor resection, when curative tumor resection cannot be performed.
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Forty-nine patients with T3 and T4 carcinoma of the gallbladder were treated by three different regimens. Group 1 consisted of 26 patients treated with combined resection alone; group 2 was twelve patients whose tumors had spread to the hepatoduodenal ligament treated with combined resection plus intraoperative radiation therapy; group 3 comprised eleven patients with nonresectable tumors treated with hyperthermia in combination with chemoradiation therapy (HCRT). The difference in the survival rates between group 1 and 2 were statistically significant (p < 0.001); however, the difference between group 2 and 3 was not significant. In group 1, there was a significant difference between patients with and without lymph node involvement in the 3-year survival rate (p < 0.01). Thus, the only patients without involvement of regional lymph nodes and the hepatoduodenal ligament have the best potential for long-term survival through aggressive surgical approaches. HCRT may provide an alternative palliation for patients with advanced carcinoma showing obstructive jaundice.