Abstract
BackgroundGastric bleeding negatively impacts the quality of life of patients with unresectable advanced gastric cancer and is frequently lethal. We investigated the efficacy of RT for palliation of gastric bleeding from gastric cancer and identified an optimal radiotherapy (RT) strategy.MethodsThe study analyzed 57 patients submitted to palliative RT for gastric bleeding associated with gastric cancer between January 2009 and February 2019. Changes in hemoglobin (Hb) levels were analyzed based on measurements taken before and immediately, 1 month, and 2 months after RT. Re-bleeding after RT was identified as either Hb level dropping to < 7.0 g/dL or the administration of a blood transfusion after RT.ResultsThe median biologically effective dose (α/β = 10) was 37.5 Gy (range 23.6–58.5). The most common regimen was 25 Gy in five fractions. The mean Hb levels before, immediately after, 1 month, and 2 months after RT (6.6, 9.7, 10.3, and 9.7 g/dL, respectively) were significantly higher than that before RT (all p < 0.001). No significant differences in re-bleeding rates were observed according to total dose, fractional dose, and fraction number. Gastric tumor response evaluated by computed tomography within 2 months after RT showed partial responses were more frequent in patients achieving bleeding control (25.0% vs. 10.8%, p = 0.023) and overall survival was significantly improved for bleeding control within 3 months after RT (median, 15.4 vs. 10.0 weeks, p = 0.048).ConclusionsRT was an effective modality for gastric bleeding control in gastric cancer, which can be achieved with a short course scheme with five fractions.
Highlights
Gastric bleeding negatively impacts the quality of life of patients with unresectable advanced gastric cancer and is frequently lethal
Bleeding caused by gastric cancer degrades patient quality but can lead to life-threatening conditions due to hematological instability. This deterioration of patient condition interferes with cancer treatment; failure to control bleeding can lead to a poor prognosis [5]
This study investigated the efficacy of RT for palliation of gastric cancer-associated gastric bleeding and suggested an optimal RT strategy
Summary
Gastric bleeding negatively impacts the quality of life of patients with unresectable advanced gastric cancer and is frequently lethal. Bleeding caused by gastric cancer degrades patient quality but can lead to life-threatening conditions due to hematological instability. This deterioration of patient condition interferes with cancer treatment; failure to control bleeding can lead to a poor prognosis [5]. Treatments for bleeding control include endoscopic therapy, transcatheter arterial embolization, and radiotherapy (RT). Endoscopic therapy showed hemostasis rates of 73–100%, making it excellent for bleeding control; the re-bleeding rates were approximately 40% [5,6,7]. Predicted endoscopic hemostasis failure was higher for large bleeding lesions (> 2 cm)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
