Lee Jung Ae, Lim Do Hoon, Park Won, Ahn Yong Chan, Huh Seung Jae
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Tumori. 2009 Nov-Dec;95(6):726-30. doi: 10.1177/030089160909500615.
To evaluate the outcome of palliative radiotherapy (RT) for patients with gastric cancer bleeding.
A retrospective review of 30 patients with gastric cancer bleeding who underwent palliative RT was conducted. Twenty-three patients who received a dose of > or = 30 Gy in 10 fractions were eligible. The palliative effect was evaluated both in a subjective and objective manner. Subjective symptomatic relief of bleeding was determined and an objective response was evaluated by identifying the amount of transfused packed red blood cells (PRBC) and the mean hemoglobin (Hb) level of patients before and after RT.
Subjective symptom relief was observed in 21 patients. The number of transfused PRBC units was 2 to 25 (median, 6) during the month before RT and 0 to 16 (median, 0) during the month after RT (P < 0.001). The average level of Hb increased from 9.1 +/- 1.6 g/dL to 10.6 +/- 1.6 g/dL (P < 0.001). In 9 patients whose laboratory findings were available for > or = 3 months after RT, the mean Hb at one, two, and three months after RT was 10.7 +/- 1.7 g/dL (P = 0.004), 10.5 +/- 1.0 g/dL (P = 0.039), and 9.9 +/- 1.0 g/dL (P = 0.164), respectively. The median number of transfused PRBC units decreased from 6 to 0 during the three months after RT.
RT may be an effective treatment for gastric cancer bleeding when other modalities are not feasible. In this study, 91% of the patients experienced symptomatic palliation with an elevated Hb level and a decreased number of transfusions after RT.
评估姑息性放疗（RT）对胃癌出血患者的治疗效果。
对30例行姑息性RT的胃癌出血患者进行回顾性研究。23例接受10次分割剂量≥30 Gy的患者符合条件。从主观和客观两方面评估姑息治疗效果。确定出血的主观症状缓解情况，并通过确定放疗前后患者输注的浓缩红细胞（PRBC）数量和平均血红蛋白（Hb）水平来评估客观反应。
21例患者出现主观症状缓解。放疗前1个月输注PRBC的单位数为2至25（中位数为6），放疗后1个月为0至16（中位数为0）（P<0.001）。Hb平均水平从9.1±1.6 g/dL升至10.6±1.6 g/dL（P<0.001）。9例放疗后实验室检查结果可得≥3个月的患者，放疗后1个月、2个月和3个月的平均Hb分别为10.7±1.7 g/dL（P = 0.004）、10.5±1.0 g/dL（P = 0.039）和9.9±1.0 g/dL（P = 0.164）。放疗后3个月内输注PRBC的单位数中位数从6降至0。
当其他治疗方式不可行时，RT可能是治疗胃癌出血的有效方法。在本研究中，91%的患者在放疗后症状得到缓解，Hb水平升高且输血次数减少。
