Intravascular Brachytherapy via the Inferior Vena Cava: An Adjunctive Treatment for Pancreatic Cancer

Abstract

JVIR 2000; 11:729–732 ADENOCARCINOMA is the most common tumor of the pancreas and is now the fifth leading cause of cancer deaths in the United States (1,2). Although multiple regimens and approaches have been used in attempts to treat pancreatic cancer, the overall survival rate remains dismal. Surgical resection has been the mainstay of attempted curative therapy for pancreatic carcinoma for many years. Only 10%–15% of patients with pancreatic cancer are able to undergo “potential” curative resection, and those who do have a 5-year survival of less than 20% (3). Because pancreatic cancer at presentation is rarely a localized process, surgery alone is unlikely to increase survival in the absence of adjuvant therapy (4). Current available adjuvant modalities include chemotherapy, neoadjuvant chemotherapy, intraperitoneal chemotherapy, external beam radiation, preoperative radiation, intraoperative radiation therapy and brachytherapy. Brachytherapy has been applied interstitially, intraluminally (within the biliary ducts), and appositionally (close to or actually touching the tumor) (5,6). We report a case of pancreatic adenocarcinoma treated with adjuvant brachytherapy through a catheter positioned in the inferior vena cava (IVC). To our knowledge, this approach has not been previously described.