Department of Radiation Oncology, National University Hospital, National Cancer Institute of Singapore, Singapore, Singapore.
National Registry of Diseases, Singapore, Singapore.
Cancer Med. 2019 Apr;8(4):1447-1458. doi: 10.1002/cam4.2021. Epub 2019 Feb 20.
To evaluate the response and quality of life of palliative gastric radiotherapy in patients with symptomatic locally advanced gastric cancer. Patients with bleeding, pain or obstruction and were treated with palliative gastric radiotherapy to a dose of 36 Gy in 12 daily fractions. The primary outcomes were symptom response rates. Secondary outcomes included overall survival, adverse events and proportion of patients with ≥10-point absolute improvement in the fatigue, nausea/vomiting and pain subscales in the EORTC Qualify of Life Questionnaire C30 (EORTC QLQ-C30) and dysphagia/pain subscales in the gastric specific module (STO22) at the end of RT and 1 month after the completion of radiotherapy. Fifty patients were accrued. Median survival duration was 85 days. 40/50 patients (80%) with bleeding, 2/2 (100%) patients with obstruction and 1/1 (100%) patient with pain responded to radiotherapy. Improvements fatigue, nausea/vomiting and pain subscales of the EORTC QLQ-C30 was seen in 50%, 28% and 44% of patients at the end of RT and in 63%, 31% and 50% of patients 1 month after RT. Improvements in dysphagia/pain subscales of the STO22 was seen in 42% and 28% of patients at then end of RT and 44% and 19% of patients 1 month after RT. Two patients (5%) had grade 3 anorexia and gastritis. Palliative gastric radiotherapy was effective, well tolerated and resulted in improvement in fatigue, dysphagia and pain at the end of radiotherapy and 1 month after the completion of radiotherapy in a significant proportion of patients.
评估姑息性胃放疗治疗有症状局部晚期胃癌患者的反应和生活质量。对有出血、疼痛或梗阻症状的患者进行姑息性胃放疗，剂量为 36Gy，分 12 次每日剂量。主要结局指标为症状缓解率。次要结局指标包括总生存时间、不良事件以及 EORTC 生活质量问卷核心 30 量表（EORTC QLQ-C30）中疲劳、恶心/呕吐和疼痛子量表和胃特异性模块（STO22）中吞咽困难/疼痛子量表在放疗结束时和放疗结束后 1 个月时绝对改善≥10 分的患者比例。共入组 50 例患者。中位生存时间为 85 天。40/50 例（80%）有出血、2/2 例（100%）有梗阻和 1/1 例（100%）有疼痛的患者对放疗有反应。放疗结束时，EORTC QLQ-C30 的疲劳、恶心/呕吐和疼痛子量表改善分别见于 50%、28%和 44%的患者，放疗结束后 1 个月时分别见于 63%、31%和 50%的患者。STO22 的吞咽困难/疼痛子量表在放疗结束时和放疗结束后 1 个月时分别有 42%和 28%的患者和 44%和 19%的患者改善。2 例（5%）患者出现 3 级厌食和胃炎。姑息性胃放疗有效且耐受良好，可显著改善患者的疲劳、吞咽困难和疼痛，在放疗结束时和放疗结束后 1 个月时均可改善。
