Division of Radiation Oncology, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi, Shizuoka 411-8777, Japan.
J Cancer Res Clin Oncol. 2011 Jan;137(1):125-30. doi: 10.1007/s00432-010-0866-z. Epub 2010 Mar 25.
To evaluate the effectiveness of short-course radiotherapy (RT) with 30 Gy in 10 fractions for bleeding from advanced gastric cancer.
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.
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.
RT with 30 Gy in 10 fractions is an adequate treatment for bleeding from advanced gastric cancer, especially in patients with poor prognosis.
评估 30Gy/10 次短程放疗治疗晚期胃癌出血的疗效。
我们回顾了 2002 年 9 月至 2007 年 3 月在静冈癌症中心医院因胃出血接受放疗且需要输血的所有胃癌患者的数据。排除了接受根治性放化疗或既往放疗的患者。放疗计划总剂量为 30Gy，单次剂量为 3Gy。如果患者在放疗后 1 个月或以上不需要输血，则认为放疗有效。
30 例患者中有 22 例（73%）对放疗有反应，22 例有反应的患者中有 11 例（50%）再次出血。再次出血的中位累积时间为 3.3 个月。12 例患者接受同期放化疗，其再出血率明显低于单纯放疗患者（P=0.001）。在接受 CRT 的患者中，观察到 1 例 3 级非血液学毒性和 5 例 3-4 级血液学毒性。单独接受 RT 的患者未观察到 3 级或更高级别的不良事件。
30Gy/10 次短程放疗是治疗晚期胃癌出血的有效方法，尤其是在预后不良的患者中。
