The Radiation Oncology Branch and Surgery Branches of the National Cancer Institute have been involved in prospectively randomized studies evaluating the potential role of intraoperative radiation therapy in several disease sites, including resectable and unresectable carcinomas of the pancreas, resectable carcinomas of the stomach, and retroperitoneal sarcomas. One hundred patients have been treated with experimental intraoperative radiation therapy, and randomized to either receive or not receive radiation therapy intraoperatively with large single doses of electrons. There is really no suggestion of improvement in survival, or in disease-free survival. There is some suggestion of an improvement of local control in the retroperitoneum itself; however, this is off-set by a high predilection for seeding of the abdominal cavity, either peritoneal carcinomatosis or sarcomatosis, thus neutralizing the potential benefit of intraoperative radiation. The trials on pancreatic carcinoma and retroperitoneal sarcomas have been closed. The gastric study is still open for patient accrual.
