Tsuchida Kazuhito, Saeki Hiroyuki, Yasukawa Mio, Toda Soji, Kamioka Yuto, Suematsu Hideaki, Numata Koji, Higuchi Akio, Matsukawa Hiroshi, Oka Hiroyuki, Okazaki Hiroshi, Tayama Yoshifumi, Rino Yasushi, Masuda Munetaka
Dept. of Surgery, Yokohama Minami Kyousai Hospital.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2500-2502.
Only a few studies have been conducted regarding the palliative radiation therapy(RT)for gastric cancer(GC)bleeding. Data of 9 patients with gastric cancer requiring blood transfusions due to gastric bleeding who were treated with RT were reviewed. All patients were men with a median age of 83(range, 70-91)years. The clinical stage was ⅡB in 2 patients, Ⅲin 1, ⅣA in 1, and ⅣB in 5. Performing gastrectomy was difficult in 4 patients with distant metastasis or tumor invasion to adjacent organ, 3 with poor performance status, and 2 with advanced age. The median hemoglobin levels before RT was 6.0 (range, 3.3-7.7)g/dL, and all patients received blood transfusions before RT. Seven patients received 30 Gy RT and 2 patients received 50 Gy. Two patients received concurrent chemotherapy. A total of 2 hematological and 4 non-hematological treatment-related adverse events occurred. All patients improved conservatively. Hemorrhage occurred in 8 patients, except for 1. Of the 8 patients who responded to RT, 1 had rebleeding on day 81. The median rebleeding-free survival time from the beginning of RT was 125(range, 21-421)days. Palliative radiation therapy was useful for bleeding control in nonresectable gastric cancer.
关于胃癌（GC）出血的姑息性放射治疗（RT），仅有少数研究。我们回顾了9例因胃出血需要输血且接受RT治疗的胃癌患者的数据。所有患者均为男性，中位年龄83岁（范围70 - 91岁）。临床分期为ⅡB期2例，Ⅲ期1例，ⅣA期1例，ⅣB期5例。4例有远处转移或肿瘤侵犯相邻器官、3例身体状况较差、2例年龄较大的患者难以进行胃切除术。RT前中位血红蛋白水平为6.0（范围3.3 - 7.7）g/dL，所有患者在RT前均接受了输血。7例患者接受了30 Gy的RT，2例患者接受了50 Gy的RT。2例患者接受了同步化疗。共发生2例血液学和4例非血液学治疗相关不良事件。所有患者经保守治疗后病情改善。除1例患者外，8例患者发生出血。在对RT有反应的8例患者中，1例在第81天再次出血。从RT开始计算，中位无再出血生存时间为125天（范围21 - 421天）。姑息性放射治疗对不可切除胃癌的出血控制有效。
