Use of intraoperative radiotherapy as part of the combined treatment of borderline resectable locally advanced pancreatic cancer Case report

Abstract

Cancer remains a disease with a poor prognosis, due to late diagnosis, the progression of the disease, and the need for radical treatment. The specific risks associated with marginal resection margins, where radical resection is performed, are challenging and often involve additional microscopic resection margins. The objective of the present study was to evaluate the efficacy of intraoperative radiotherapy (IORT ) as a component of multimodal cancer treatment. A 70-year-old patient with a tail tumor, classified as borderline resectable, received first-line chemotherapy according to the FOLFIRINOX regimen. This was followed by preoperative chemoradiotherapy, adjuvant therapy, and IORT . The treatment was well tolerated, with no postoperative complications related to IORT . A partial response to treatment was achieved, along with local control, thereby preventing disease progression and metastasis. The extant literature indicates that intraoperative radiotherapy may be a concomitant modality with multimodal therapy in patients with resectable cancer, particularly in cases of high-risk disease. This technique facilitates the irradiation of the tumor bed while concomitantly limiting exposure to critical risks. Whilst the benefits in terms of local control are recognized, the impact of IORT on overall survival remains unclear and requires further research.