Andleeb Asifa, Fatima Kaneez, Nasreen Shahida, Sofi Mushtaq Ahmad, Najmi Arshad Manzoor, Qadri Sumaira, Siraj Farhana
Department of Radiation Oncology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Department of Pathology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Indian J Palliat Care. 2023 Jul-Sep;29(3):279-284. doi: 10.25259/IJPC_1_2023. Epub 2023 Jun 12.
The aim of our study is to see the efficacy of palliative radiotherapy (RT) for bleeding control in patients with advanced gastric cancer (AGC).
It is a retrospective review based on observations of 74 AGC patients with a median age of 60 years (range 50-82 years) who had active tumour bleeding and were treated with palliative RT. Treatment response was assessed by both subjective symptom relief and objective change in parameters. Objective response to RT was defined by an increase in the median haemoglobin (Hb) level of patients and a decrease in number of packed red blood cell (RBC) units needed by patients after RT.
Response to haemostatic RT was observed in 52 patients out of 74 patients (70.27%). We observed a significant increase in mean Hb level after palliative RT. Pre-RT mean Hb was 6.14 ± 1.01 and post-RT mean Hb was 7.19 ± 1.75 ( < 0.05). Response to RT was also evident in a significant decrease in the number of packed RBC units post-haemostatic RT. The mean number of pre-RT transfused packed RBC units was 8.28 ± 3.76 and post-RT, it was 4.34 ± 2.91 (P < 0.05). The median overall survival was 90 days and the median transfusion-free survival was 40 days.
RT may be an effective treatment option for bleeding control in AGC. In our study, we observed fair and reasonably durable haemostasis. A success rate of 70.24% was documented with clinical palliation, a higher Hb level and fewer transfusions after RT. This modality for bleeding control is more important and reliable in situations where alternative modalities are not feasible.
本研究旨在观察姑息性放疗（RT）对晚期胃癌（AGC）患者出血控制的疗效。
这是一项回顾性研究，基于对74例AGC患者的观察，患者中位年龄为60岁（范围50 - 82岁），这些患者有活动性肿瘤出血并接受了姑息性放疗。通过主观症状缓解和参数的客观变化来评估治疗反应。放疗的客观反应定义为患者中位血红蛋白（Hb）水平升高以及放疗后患者所需浓缩红细胞（RBC）单位数量减少。
74例患者中有52例（70.27%）观察到对止血放疗有反应。我们观察到姑息性放疗后平均Hb水平显著升高。放疗前平均Hb为6.14±1.01，放疗后平均Hb为7.19±1.75（P<0.05）。放疗后的反应还明显表现为止血放疗后浓缩RBC单位数量显著减少。放疗前输注的浓缩RBC单位平均数量为8.28±3.76，放疗后为4.34±2.91（P<0.05）。中位总生存期为90天，中位无输血生存期为40天。
放疗可能是控制AGC出血的有效治疗选择。在我们的研究中，观察到了较好且相当持久的止血效果。记录的临床缓解成功率为70.24%，放疗后Hb水平更高且输血次数更少。在其他替代方法不可行的情况下，这种出血控制方式更为重要且可靠。
