Clinical observation on palliative radiotherapy for gastric hemorrhage in patients with advanced gastric cancer

LIU Yi; NI Feng; CAO Guangxin; WANG Ding

doi:10.3969/j.issn.1009-0460.2023.10.014

Abstract：Objective To explore the efficacy of palliative radiotherapy(RT)in alleviating gastric bleeding associated with advanced gastric cancer and determine the optimal RT regimen.Methods A retrospective analysis was conducted on 53 patients who received palliative RT treatment for gastric cancer related gastric bleeding in our hospital from January 2016 to February 2022.Analyze baseline hemoglobin(Hb)within one month before RT,Hb at the end of RT,Hb at one month after RT,and Hb at two months after RT.Re bleeding after RT is defined as a decrease in Hb level to 7.0 g/dL or the need for additional blood transfusion.Results The bleeding in 38 patients was controlled after radiotherapy.The median time from palliative RT to bleeding control was 12.5 days(1-68 days).The median baseline Hb level in the first month of RT was 6.85 g/dL(3.4-10.7),while the median baseline Hb levels immediately,1 month,and 2 months after RT were 8.20 g/dL,10.20 g/dL,and 10.80 g/dL,respectively,which were higher than the baseline Hb level(P＜0.001).The median cumulative no bleeding(CRR)duration after RT was 51 days(4-370 days).According to the biological effective dose(BED10)stratification,the median CRR duration was 44 days in the BED10＜39.2 Gy group and 74 days in the BED10≥39.2 Gy group,respectively,with statistically significant differences(P＜0.001).Cox risk proportional regression model analysis showed that younger age(P=0.001),post RT chemotherapy(P＜0.001),and higher BED10(P=0.024)were influencing factors for prolonging rebleeding time.Conclusion Palliative RT with high BED10 is an effective way to control gastric bleeding associated with advanced gastric cancer.