Published in:
01-01-2011 | Original Paper
Palliative radiotherapy for bleeding from advanced gastric cancer: is a schedule of 30 Gy in 10 fractions adequate?
Published in: Journal of Cancer Research and Clinical Oncology | Issue 1/2011
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Purpose
To evaluate the effectiveness of short-course radiotherapy (RT) with 30 Gy in 10 fractions for bleeding from advanced gastric cancer.
Methods
We reviewed the data for all patients with gastric cancer requiring blood transfusions due to gastric bleeding who were treated with RT at the Shizuoka Cancer Center Hospital between September 2002 and March 2007. Patients with curative-intent chemoradiotherapy or previous irradiation were excluded. RT was planned to deliver a total of 30 Gy at 3 Gy per fraction. We defined RT as effective if the patients did not require blood transfusions for 1 or more months after RT.
Results
Twenty-two out of 30 patients (73%) responded to RT, and rebleeding occurred in 11 (50%) of 22 patients responding to RT. The median actuarial time to rebleeding was 3.3 months. Twelve patients received concurrent chemoradiotherapy and had a significantly lower rebleeding rate than patients undergoing RT alone (P = 0.001). Among patients receiving CRT, 1 with grade 3 non-hematological toxicity and 5 with grade 3–4 hematological toxicity were observed. No Grade 3 or higher adverse events were observed in patients treated with RT alone.
Conclusions
RT with 30 Gy in 10 fractions is an adequate treatment for bleeding from advanced gastric cancer, especially in patients with poor prognosis.