Treatment of gastric cancer with combined surgery and intraoperative radiotherapy.

Abstract

AbstractIn order to increase the cure rate of stomach cancer, we have used intraoperative radiotherapy in which resectable lesions are removed surgically and the remaining cancer nests sterilized with a single massive dose of irradiation during laparotomy. In cooperation with surgeons, radiologists, and anesthesiologists, effective doses of irradiation of 3,000–4,000 rads were administered in 85 patients with advanced cancer. After resection of the stomach and removal of regional lymph nodes, and before gastrojejunostomy, the region of the celiac axis was irradiated in order to destroy regional microscopic metastasis that could not be removed surgically. The survival rates were 0 of 8 patients with nonresectable lesions, 3 of 15 with absolutely noncurable resectable tumors, 6 of 11 with relatively noncurable resectable cancers, and 48 of 51 with absolutely or relatively curable resectable lesions. In the latter group, insufficient time has elapsed to calculate the 5‐year survival rate. No serious complications occurred except for an increase of serum amylase. These results, as well as experimental radiotherapy of the dog pancreas, are discussed.