Tanaka Osamu
Asahi University Hospital, Department of Radiation Oncology, Gifu, 500-8523, Japan.
Tech Innov Patient Support Radiat Oncol. 2024 Jul 31;31:100266. doi: 10.1016/j.tipsro.2024.100266. eCollection 2024 Sep.
Gastric cancer has a high prevalence in Asia and may only be diagnosed in advanced stages. Therefore, patients with gastric cancer may experience fatal symptoms, such as bleeding or stenosis at the time of consultation. In this review, we aimed to describe the effectiveness and toxicity of hemostatic radiotherapy (RT).
A total of 17 retrospective and 3 prospective studies were analyzed. The prescription dose, biologically effective dose, equivalent dose in 2 Gy fractions, response rate, survival prognosis, and toxicities were also reported.
Using 20 studies, the following observations were made the hemostatic effect was ∼ 80 %, the mean survival time after irradiation was about 3 months, and prescribed doses of 30 Gy/10 fractions and 20 Gy/5 fractions were considered suitable.
In this review, studies on hemostatic irradiation have been summarized, and the most optimal treatment method has been proposed. 30 Gy/10 fractions and 20 Gy/5 fractions were ideal. However, because palliative RT is preferably completed within a short period of time, a randomized trial is needed to determine whether the 8 Gy/single fraction treatment is equivalent to fractionated RT. Therefore, more prospective studies are warranted to establish a standard of care for palliative RT in gastric cancer.
胃癌在亚洲发病率很高，且可能在晚期才被诊断出来。因此，胃癌患者在就诊时可能会出现致命症状，如出血或狭窄。在本综述中，我们旨在描述止血放疗（RT）的有效性和毒性。
共分析了17项回顾性研究和3项前瞻性研究。还报告了处方剂量、生物等效剂量、2Gy分割等效剂量、缓解率、生存预后和毒性。
通过20项研究得出以下观察结果：止血效果约为80%，照射后的平均生存时间约为3个月，30Gy/10次分割和20Gy/5次分割的处方剂量被认为是合适的。
在本综述中，总结了止血放疗的研究，并提出了最优化的治疗方法。30Gy/10次分割和20Gy/5次分割是理想的。然而，由于姑息性放疗最好在短时间内完成，需要进行一项随机试验来确定8Gy单次分割治疗是否等同于分割放疗。因此，有必要开展更多前瞻性研究，以确立胃癌姑息性放疗的护理标准。
