Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
BMC Cancer. 2021 Apr 15;21(1):413. doi: 10.1186/s12885-021-08145-4.
This study analyzed the clinical results of palliative radiotherapy for bleeding control in patients with unresectable advanced gastric cancer.
We retrospectively reviewed the medical records of patients who met the following inclusion criteria between January 2002 and June 2018: histologically proven gastric cancer, gastric tumor bleeding confirmed by upper gastrointestinal endoscopy, and palliative radiotherapy performed for hemostasis. The median radiotherapy dose was 30 Gy, with a daily dose ranging from 1.8 to 3 Gy.
Sixty-one patients were included in this analysis. The study population was predominantly male (72.1%), with a median age of 62 years (range: 32-92). The median baseline hemoglobin level was 7.1 g/dL, and the most common presenting symptom of gastric tumor bleeding was melena (85.2%). Bleeding control was achieved in 54 (88.5%) patients. The median levels of hemoglobin at 1, 2, and 3 months after completion of radiotherapy were 10.1 g/dL, 10.2 g/dL, and 10.4 g/dL, respectively; these values were significantly different from that before radiotherapy (7.1 g/dL; p < 0.001). The median overall survival was 4.8 months. Among the 54 patients who achieved bleeding control after radiotherapy, 19 (35.2%) experienced re-bleeding during the follow-up period. The median time to re-bleeding was 6.0 months. Multivariate analysis demonstrated that a higher radiation dose (p = 0.007) and additional chemotherapy after radiotherapy (p = 0.004) were significant factors for prolonging the time to re-bleeding.
Tumor bleeding was adequately controlled by radiotherapy in patients with unresectable advanced gastric cancer.
本研究分析了姑息性放疗在不可切除的晚期胃癌患者中控制出血的临床效果。
我们回顾性分析了 2002 年 1 月至 2018 年 6 月期间符合以下纳入标准的患者的病历：组织学证实的胃癌、上消化道内镜证实的胃肿瘤出血、以及为止血而行姑息性放疗。中位放疗剂量为 30Gy，日剂量范围为 1.8 至 3Gy。
本分析纳入了 61 例患者。研究人群主要为男性（72.1%），中位年龄为 62 岁（范围：32-92 岁）。中位基线血红蛋白水平为 7.1g/dL，胃肿瘤出血的最常见表现为黑便（85.2%）。54 例（88.5%）患者达到了出血控制。放疗完成后 1、2 和 3 个月的血红蛋白中位数分别为 10.1g/dL、10.2g/dL 和 10.4g/dL，与放疗前相比有显著差异（7.1g/dL；p<0.001）。中位总生存期为 4.8 个月。在放疗后达到出血控制的 54 例患者中，有 19 例（35.2%）在随访期间再次出血。再次出血的中位时间为 6.0 个月。多变量分析表明，较高的放疗剂量（p=0.007）和放疗后附加化疗（p=0.004）是延长再次出血时间的显著因素。
姑息性放疗可有效控制不可切除的晚期胃癌患者的肿瘤出血。
