Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan.
Department of Gastroenterological Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan.
J Gastrointest Cancer. 2022 Jun;53(2):420-426. doi: 10.1007/s12029-021-00632-y. Epub 2021 Mar 23.
Bleeding from unresectable gastric cancer is a localized condition that adversely affects quality of life. Radiotherapy can be used to treat gastric cancer bleeding when surgery, endoscopic treatment, and intravascular embolization are ineffective. This study evaluated the utility of radiotherapy for unresectable hemorrhagic gastric cancer.
We retrospectively analyzed data from 33 patients with gastric cancer bleeding who underwent palliative radiotherapy in our hospital between April 2013 and May 2020. In this study, successful hemostasis was defined as > 1 month after starting radiotherapy with the patient alive and showing no need for blood transfusion, no drop in hemoglobin, and no evidence of melena or hematemesis.
Patients comprised 26 men (79%) and 7 women (21%), with a median age of 71 years (range, 41-78 years). Hemostasis was achieved in 24 patients (73%). Thirty-two patients (94%) have been discharged home or transferred to the hospice. Patients with successful hemostasis from radiotherapy showed significantly longer overall survival than patients with unsuccessful hemostasis (p = 0.0026). No toxicities of grade 2 or more were encountered.
This retrospective study found that palliative radiotherapy for gastric cancer bleeding was useful and safe and can improve remaining quality of life in patients with poor prognosis.
不可切除的胃癌出血是一种局部状况，会对生活质量产生不利影响。当手术、内镜治疗和血管内栓塞无效时，可以使用放疗来治疗胃癌出血。本研究评估了放疗对不可切除的出血性胃癌的疗效。
我们回顾性分析了 2013 年 4 月至 2020 年 5 月期间在我院接受姑息性放疗的 33 例胃癌出血患者的数据。在本研究中，成功止血定义为开始放疗后>1 个月，患者存活且无需输血，血红蛋白无下降，无黑便或呕血迹象。
患者包括 26 名男性（79%）和 7 名女性（21%），中位年龄为 71 岁（范围为 41-78 岁）。24 例患者（73%）止血成功。32 例患者（94%）已出院回家或转至临终关怀病房。从放疗中止血成功的患者总生存期明显长于止血不成功的患者（p=0.0026）。未发生 2 级及以上毒性。
这项回顾性研究发现，姑息性放疗治疗胃癌出血是有用且安全的，可以提高预后不良患者的剩余生活质量。
