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Endoscopy 2002; 34(7): 555-559
DOI: 10.1055/s-2002-33214
Original Article
© Georg Thieme Verlag Stuttgart · New York

Treatment of Unresectable Pancreatic Carcinoma by Intraluminal Brachytherapy in the Duct of Wirsung

M.  Mutignani 1 , S.  K.  Shah 1 , A.  G.  Morganti 2 , V.  Perri 1 , G.  Macchia 2 , G.  Costamagna 1
  • 1Digestive Endoscopy Unit , Università Cattolica del Sacro Cuore, Rome, Italy
  • 2Department of Radiotherapy, Università Cattolica del Sacro Cuore, Rome, Italy
Further Information

Publication History

Submitted 30 August 2001

Accepted after Revision 19 February 2002

Publication Date:
12 August 2002 (online)

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Background and Study Aims: Our aim was to evaluate the feasibility and clinical outcome of intraluminal brachytherapy (ILBT) in the duct of Wirsung in patients with unresectable pancreatic adenocarcinoma.
Patients and Methods: Nine patients (eight men, one woman; mean age 72.4 ± 9.1, range 52 - 80) with unresectable pancreatic adenocarcinoma of the head or body underwent ERCP for biliary and/or pancreatic stent placement and placement of a nasopancreatic drain with/without nasobiliary drain. The ILBT dose administered was 30 - 50 Gy calculated at 1 cm from the iridium-192 wire axis. Seven patients received ILBT from the duct of Wirsung whereas two patients received dual-duct ILBT (duct of Wirsung and the common bile duct). Three patients received combined-modality treatment (ILBT with external beam radiotherapy and 5-fluorouracil). The patients were prospectively followed up.
Results: No endoscopy-related complications occurred. No radiation-related toxicity occurred in patients treated with ILBT alone. One patient undergoing combined-modality treatment developed gastric bleeding. Intraluminal source dislodgement occurred in three patients. Obvious tumor mass reduction of greater than 50 % was seen in three patients at 8 weeks after brachytherapy. Median survival was 11 months (range 6 - 37 months) and the 1-year and 3-year actuarial survival rates were 44 % and 15 %, respectively.
Conclusion: Intraluminal brachytherapy in the duct of Wirsung in patients with unresectable pancreatic carcinoma is safe and feasible. Further clinical trials are warranted.

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G. Costamagna, M.D.

Digestive Endoscopy Unit · “A. Gemelli” University Hospital

Largo A. Gemelli 8 · 00168 Rome · Italy

Fax: + 39-06-35511515

Email: gcostamagna@rm.unicatt.it