膵癌の放射線療法

Radiotherapy for Cancer of the Pancreas

要旨　12例の膵癌に術中照射あるいは外部照射を行った．術中照射例5例のうち切除例の3例にはベータトロン6～10MeⅤ2,500～3,000radが照射されたが1例は膵壊死のため術後0.7ヵ月で死亡した．1例は8.5ヵ月後肝転移で死亡したが照射野に再発はみられなかった．他の1例は1.5カ月生存中である．非切除例2例にはベータトロン13～16MeⅤ2,500～3,000radを照射し術後0.5～1.0カ月現在生存中である．外部照射例7例にはライナック10MeⅤ2,800～5,000radが照射された．うち2例の切除例は術後13.4カ月全身衰弱死亡例，9.5カ月生存例である．5例の非切除例はいずれも肝，肺への遠隔転移または腹膜播種例で延命効果は認められなかったが腫瘍の縮小，腹痛の消失などperformance statusの改善が認められた．

　Twelve patients with cancer of the pancreas underwent intraoperative radiation (n＝5) or external radiation (n＝7) therapy. Of the five patients with intraoperative radiotherapy, three patients who had pancreatectomy received a dose of 2,500～3,000 rad on the 6～10 MeⅤ Betatron (Fig. 3). One patient developed radiation pancreatitis and died 0.7 month after the surgery. One died of hepatic metastasis 8.5 months after the surgery, however, recurrence was not found in the radiation field. The other one is alive for 1.5 months after the surgery. For two patients with unresectable cancer, a dose of 2,500～3,000 rad using 13～16 MeⅤ Betatron was irradiated intraoperatively. These two patients are alive for 0.5 and 1.0 months after the surgery (Table 1).

　Seven patients were treated with external beam radiation with a dose of 2,800～5,000 rad using 10 MeⅤ lineac x-ray (Fig. 5). Of two patients with pancreatectomy, one died of recurrent disease 13.4 months after the surgery and one is alive for 9.5 months after the surgery. In five patients with distant metastases to the liver, lung or peritoneal dissemination, external beam irradiation did not produce any prolongation of their survivals, however, remarkable effects on performance status were obtained (Table 2).