Selecting patients for more intense radiation therapy will require a better understanding of the biology of tumors that tend to recur locally as opposed to distantly and the deployment of techniques to achieve this intensification of radiation therapy safely and effectively. Judicious use of IORT for borderline resectable/unresectable pancreatic cancer patients will ideally be confined to
Inhibitors,research,lifescience,medical patients who (I) receive induction chemotherapy, consolidation chemoradiation, and surgical resection, where possible; (II) undergo prospective collection of selleck inhibitor biomarkers (clinical, radiographic, biochemical or molecular) predictive of local-dominant biology; and (III) are monitored prospectively for toxicity. Vigilance for unique Inhibitors,research,lifescience,medical toxicities of IORT, for instance, was instrumental in identifying more pronounced mammographic changes in the tumor bed (increased calcifications and increased fat necrosis) as a result of IORT following lumpectomy for breast cancer (11). We also envision such studies requiring the concerted effort of a consortium of centers that have IORT capabilities and expertise with pancreatic cancer management, possibly under the auspices of the American College of Surgeons
Oncology Group (ACOSOG) and/or the International Society of Intraoperative Radiation Therapy (ISIORT). Acknowledgements Disclosure: Inhibitors,research,lifescience,medical The authors declare no conflict of interest.
The majority of pancreatic tumours are primary. Pancreatic metastases are rare (3,8% of pancreatic lesions) (1), and are more commonly Inhibitors,research,lifescience,medical reported
in patients with renal cell carcinoma. Metastases of ovarian cancer to the pancreas are very rare but have been reported in the literature (2). We report a very unusual case of a metachronous pancreatic metastasis from an ovarian cancer occurred 8 years after the first diagnosis. Case report We describe a 70 year-old Caucasian female with a prior history (8 years previously) of bilateral hysteroannesiectomy Inhibitors,research,lifescience,medical because of ovarian and uterine serous papillary adenocarcinoma poorly differentiated G3 (pT1c, N0), that presented with jaundice. Her past medical history revealed 4-Aminobutyrate aminotransferase hypertension, Wegener Granulomatosis and bronchial asthma. Laboratory test results included the following: bilirubin 10.1 mg/dL (normal 0.3-1.2 mg/dL); alanine aminotransferase 478 IU/L (0-40 IU/L); alkaline phosphatase 2667 IU/L (70-290 IU/L); γGT 2853 IU/L (0-50 IU/L); Ca19-9 35,3 U/mL (0.0-37 IU/mL); CA 125 90,8 U/mL (0.0-35 IU/mL). Abdominal ultrasound revealed common bile duct (CBD) dilation (20 mm diameter) with concomitant dilatation of intrahepatic biliary tree. The abdominal CT scan showed a 2.5 cm × 3 cm hypodense pancreatic head lesion involving the portal vein (Figure 1). Figure 1 Contrast enhanced CT scan of the abdomen revealing 2.