• Radiation given during the operation—intraoperative radiotherapy (IORT)—is being evaluated.
• Some trials of split course radiotherapy of 4,000 to 6,000 cGy over six to eight weeks have shown one-year
survival of 34 percent and five-year survival of 20 percent Brachytherapy—implanting irradiating seeds of
radon or boron—is under clinical evaluation at a few centers. Results so far have not been promising.
• Postoperative large-field radiation with 5-FU chemotherapy is also being evaluated and it appears that this
combination improves survival. Side effects include diarrhea, inflammation of the intestinal lining and liver
toxicity.
Palliation Eighty percent of pancreatic cancer patients have jaundice caused by an obstruction. A surgically created bypass from the gall bladder or the common bile duct to the intestine may be helpful.
Stage II
TNM T3, N0, M0
The cancer has directly spread to involve adjacent organs such as the stomach, spleen or colon.
