The role of palliative radiotherapy for haemostasis in unresectable gastric cancer: a single-institution experience.
OBJECTIVE
To evaluate the outcomes of patients with gastric cancer bleeding who had been treated with palliative radiotherapy with haemostatic intent.


METHODS
Fifty-two gastric cancer patients aged 52-92 years (median 78 years) with active bleeding or anaemia resulting from inoperable gastric cancer were treated with short-course radiotherapy. Responses to radiotherapy treatment were evaluated based on the changes of haemoglobin level, number of transfusions received before and after radiotherapy, and overall median survival.


RESULTS
Thirty-nine (75%) patients received single 8 Gy fraction, and 13 (25%) patients received 20 Gy in five daily fractions. The need for transfusion was evaluable in 44 patients, and the response rate was 50%, with less requirement for blood transfusions within four weeks of radiotherapy. There was also an increase in mean haemoglobin level (0.66 ± 1.12 g/dl, p < 0.01) after radiotherapy in 35 evaluable patients. The overall median survival (calculated from last day of treatment to date of death) was 160 days (95% CI of 119-201 days), making actuarial 12-month survival 15%.


CONCLUSIONS
Palliative short-course radiotherapy is a reasonably effective treatment that can provide durable palliation of bleeding in gastric cancer.
Princess Alexandra Centre, Oncology Department, Ninewells Hospital & Medical School, Dundee DD1 9SY, Scotland, UK.
Cheng Lee
CL
Chaw
Princess Alexandra Centre, Oncology Department, Ninewells Hospital & Medical School, Dundee DD1 9SY, Scotland, UK.
Paddy G
PG
Niblock
Faculty of Applied Science, Department of Pharmacy, Health and Well Being, University of Sunderland SR1 3SD, UK.
Cheng Shu
CS
Chaw
Princess Alexandra Centre, Oncology Department, Ninewells Hospital & Medical School, Dundee DD1 9SY, Scotland, UK.
Douglas J
DJ
Adamson
bleeding; gastric cancer; haemostasis; palliative; radiotherapy