Patients with gastrointestinal carcinomas have been studied for evidence of reactivity against tumor-associated determinants expressed on both fresh and cultured syngeneic or allogeneic tumor cells using immunoperoxidase staining techniques. Tumor associated antigens have been isolated from both animal and human pancreatic cancers and have been investigated for possible applications to immunotherapy or methods of immunodiagnosis. Monoclonal antibodies have been developed to tumor- associated determinants in both hamster and human tissues to intraoperative radiotherapy has been investigated in dogs to determine both acute and long-term toxicity from radiation effects. Clinical trials of intraoperative radiotherapy have been performed including feasibility and development studies, randomized trials in resectable and unresectable pancreatic carcinoma, randomized trials in gastric carcinoma, and randomized trials in retroperitoneal sarcomas. General results have indicated improved local control and decreased radiation related toxicity, especially for advanced-stage cancers. Benefit of intraoperative radiotherapy has been demonstrated in resectable pancreatic cancer, gastric cancer, and retroperitoneal sarcomas. No benefit was demonstrated in unresectable pancreatic cancer. Tolerance of normal and surgically- manipulated tissues to photodynamic therapy using hematoporphyrin derivatives and laser light has been investigated in dogs to determine toxicity and to establish dose levels applicable for clinical practice. Clinical trials of assessing the feasibility of intraperitoneal photodynamic therapy have been performed for the treatment of peritoneal carcinomatosis and peritoneal surface malignancies, including ovarian carcinoma, metastatic gastrointestinal carcinoma, and sarcomatosis. Randomized trials of intraperitoneal photodynamic therapy in retroperitoneal sarcomas have been initiated.
