Role of palliative radiotherapy in bleeding control in patients with unresectable advanced gastric cancer.

Abstract

BACKGROUND:

This study analyzed the clinical results of palliative radiotherapy for bleeding control in patients with unresectable advanced gastric cancer.

METHODS:

We retrospectively reviewed the medical records of patients who met the following inclusion criteria between January 2002 and June 2018: histologically proven gastric cancer, gastric tumor bleeding confirmed by upper gastrointestinal endoscopy, and palliative radiotherapy performed for hemostasis. The median radiotherapy dose was 30 Gy, with a daily dose ranging from 1.8 to 3 Gy.

RESULTS:

Sixty-one patients were included in this analysis. The study population was predominantly male (72.1%), with a median age of 62 years (range: 32-92). The median baseline hemoglobin level was 7.1 g/dL, and the most common presenting symptom of gastric tumor bleeding was melena (85.2%). Bleeding control was achieved in 54 (88.5%) patients. The median levels of hemoglobin at 1, 2, and 3 months after completion of radiotherapy were 10.1 g/dL, 10.2 g/dL, and 10.4 g/dL, respectively; these values were significantly different from that before radiotherapy (7.1 g/dL; p < 0.001). The median overall survival was 4.8 months. Among the 54 patients who achieved bleeding control after radiotherapy, 19 (35.2%) experienced re-bleeding during the follow-up period. The median time to re-bleeding was 6.0 months. Multivariate analysis demonstrated that a higher radiation dose (p = 0.007) and additional chemotherapy after radiotherapy (p = 0.004) were significant factors for prolonging the time to re-bleeding.

CONCLUSIONS:

Tumor bleeding was adequately controlled by radiotherapy in patients with unresectable advanced gastric cancer.

• Authors: Jesang Yu, Jinhong Jung, Sook Ryun Park, Min-Hee Ryu, Jin-Hong Park, Jong Hoon Kim, Sang Min Yoon
• Journal: BMC cancer (BMC Cancer) Vol. 21 Issue 1 Pg. 413 (Apr 15 2021) ISSN: 1471-2407 [Electronic] England
• PMID: 33858353 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Combined Modality Therapy
• Female
• Gastrointestinal Hemorrhage (diagnosis, etiology, prevention & control)
• Hemostasis
• Humans
• Male
• Middle Aged
• Neoplasm Staging
• Palliative Care (methods)
• Prognosis
• Radiotherapy, Adjuvant (adverse effects, methods)
• Retrospective Studies
• Stomach Neoplasms (blood, complications, pathology, radiotherapy)