Hemostatic Effect of Palliative Radiation Therapy in Preventing Blood Transfusions from Bleeding Occurring within Advanced Gastric Cancer

Mitsuhashi, Norio; Ikeda, Hajíme; Nemoto, Yoshitaka; Kuronuma, Mayumi; Kamiga, Masahiro; Hiroshima, Yoshinori

doi:10.1089/pmr.2021.0041

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…Although some studies (11,12,17) have shown that radiotherapy is an effective method for bleeding, our data also shows the positive contribution of palliative RT on pain relief. In a series of 115 patients, Tey et al (9) reported that 80.6% of patients had bleeding control, 45.5% had pain control, and 51.2% had obstruction palliation with palliative RT in the metastatic and nonmetastatic patient group.…”

Section: Discussioncontrasting

confidence: 49%

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Clinical outcomes of palliative 3-dimensional conformal external beam gastric radiotherapy: single center experience

ÖZTÜRK,

ALTINIŞIK İNAN,

ARAL

et al. 2023

J Med Palliat Care / JOMPAC / jompac

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Aim: Patients diagnosed with locally advanced and/or metastatic gastric cancer and who cannot undergo surgery may need palliative treatment during their follow-up. There is scarce data about outcomes of palliative gastric radiotherapy (RT). In this study, we aimed to investigate the effect of 3-D external beam RT on oncological outcomes, as a non-invasive method.Material and Method: From 2013 to 2017, sixteen gastric cancer patients treated with palliative external RT in our institutional clinic were evaluated. Only patients who received palliative gastric radiotherapy for obstruction, pain and bleeding were analyzed, and patients who had previously received RT to the abdomen or who were given RT for adjuvant purposes were not included in the analysis. Results: Seven patients (43%) were not able to finish the planned palliative course. Thirty Gray with 10 fractions was the most planned RT schedule. Almost half of the patients (%56) received chemotherapy before RT. Overall survival was found to be median 2 months. Median survival was better in patients who were able to receive 28 Gy bioequivalent dose (4 vs 0.3 months, p≤0.00). Purpose of palliation also found to be a significant factor on survival. Patients who were referred for pain have found to be better survival rather than bleeding and obstruction (13 vs 0.7 months, p=0.03).Conclusion: External radiotherapy is an easily applicable and effective method for palliation in gastric cancer patients. Early referral for radiotherapy in patients who need palliation may increase oncological outcomes. It has been observed that the prognosis is worse in patients who received palliative radiotherapy due to gastric bleeding and obstruction.

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Section: Discussioncontrasting

confidence: 49%

“…The total applied radiation dose also seems to have a role in outcomes. In the study of Mitsuashi et al (12) from Japan, where the incidence of gastric cancer is high, survival analysis was performed according to palliative RT dose.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of palliative 3-dimensional conformal external beam gastric radiotherapy: single center experience

ÖZTÜRK,

ALTINIŞIK İNAN,

ARAL

et al. 2023

J Med Palliat Care / JOMPAC / jompac

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“…All but one of the published studies regarding the use of radiation therapy for the management of bleeding secondary to AGC was a retrospective case series or case-control study, with only one non-randomized clinical trial intervention studied (16)(17)(18)(19)(20)(21)(22)(24)(25)(26)(28)(29)(30)(31)39). The most common treatment regimen was 30 Gy in 10 fractions ranging from a single 8 Gy fraction dose to 42 Gy over 20 fractions.…”

Section: Radiationmentioning

confidence: 99%

Palliative interventions for patients with advanced gastric cancer: a systematic review

Kopecky¹,

Monton²,

Rosman³

et al. 2022

Chin Clin Oncol

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Background: Gastric cancer is the fifth most common cancer and the third leading cause of cancer-related death worldwide. Advanced gastric cancer (AGC) is associated with significant morbidity and mortality and is commonly accompanied by a variety of distressing symptoms. Current National Comprehensive Cancer Network (NCCN) guidelines recommend palliative treatment modalities for patients with AGC and the treatment of AGC patients should be influenced by palliative care principles. The objective of this systematic review was to explore the published literature on palliative interventions for patients with AGC.Methods: We performed a systematic literature search to identify English language studies that investigated interventions to improve or treat the symptoms caused by AGC using PubMed, Embase, and Cochrane Library databases from January 1, 2010 to August 18, 2022. Two independent reviewers performed title and abstract review, followed by full-text review and data abstraction. Overall study quality and risk of bias was assessed using published quality assessment tools.Results: We identified 10,364 studies and included 66 studies published between 2010 and 2022 for final review. Among the studies, quality of life (QoL) metrics were most commonly a secondary outcome.Twenty-three studies addressed the palliative management of bleeding with the use of radiation therapy, surgery, arterial embolization, chemotherapy, or endoscopic interventions. Twenty-two studies addressed the management of obstructive symptoms with endoscopic stenting or surgical interventions. Most of these studies were of moderate quality and included well characterized outcomes focused on symptom reduction.Five studies assessed palliative modalities to reduce the symptomatic burden of intraabdominal ascites; these studies were less well characterized, and on average low quality. Fifteen studies of mixed quality assessed QoL for patients with AGC, with only one study evaluating specialty palliative care consultation. No studies outlined the prevalence or practices of advanced care planning in this patient population. Conclusions: Patients with AGC undergo a variety of interventions aimed at palliating the symptoms associated with their diagnosis and improving their QoL. Future research on palliative interventions for patients with AGC should utilize qualitative methodologies to measure outcomes related to symptom management and QoL, further explore the patient experience of living with AGC, and delineate best practices for advanced care planning in this population.

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“…Palliative radiotherapy has emerged as a crucial therapeutic option for managing advanced HNSCC, particularly when curative interventions may not be feasible or suitable (9, 10). Palliative radiotherapy also offers a rationale for tumor shrinkage, hemostasis, and pain relief (11,12).Accordingly, in this study, we aimed to investigate the survival outcomes of patients with HNSCC undergoing palliative radiotherapy, considering specific challenges and factors associated with older age, and offer valuable insights into the appropriate use of palliative radiotherapy in these patients. Ultimately, the results will contribute to making 46…”

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confidence: 99%

mentioning

confidence: 99%

Survival Following Palliative Radiotherapy for Head and Neck Squamous Cell Carcinoma: Examining Treatment Indications in Elderly Patients

KATANO,

MINAMITANI,

TONGYU

et al. 2024

CDP

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Background/Aim: This study investigated the survival outcomes of patients with head and neck squamous cell carcinoma (HNSCC) undergoing palliative radiotherapy, particularly focusing on challenges and factors associated with older age, providing insights into appropriate palliative radiotherapy use in this demographic. Patients and Methods: A retrospective study was conducted using electronic medical records of 73 patients with HNSCC who were deemed unsuitable for curative therapy. Palliative radiotherapy involved a uniform dose of 30 Gy in 10 fractions. Survival analysis was performed using Kaplan–Meier method, and multivariate analysis identified significant prognostic factors. Results: The median overall survival was 7.5 months, with no significant difference between age groups. Karnofsky performance status (KPS) >70 correlated with favorable survival. Multivariate analysis confirmed KPS as an independent prognostic factor (hazard ratio=1.949, p=0.031). Conclusion: The results of this study align with those of previous studies, emphasizing the importance of palliative radiotherapy for HNSCC treatment. Optimal dose fractionation regimens remain undetermined, and tailored approaches that consider factors, such as age and performance status are crucial. Individualized, comprehensive assessments and supportive care measures enhance patient well-being, reflecting palliative care principles.

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Hemostatic Effect of Palliative Radiation Therapy in Preventing Blood Transfusions from Bleeding Occurring within Advanced Gastric Cancer

Cited by 6 publications

References 24 publications

Clinical outcomes of palliative 3-dimensional conformal external beam gastric radiotherapy: single center experience

Clinical outcomes of palliative 3-dimensional conformal external beam gastric radiotherapy: single center experience

Palliative interventions for patients with advanced gastric cancer: a systematic review

Survival Following Palliative Radiotherapy for Head and Neck Squamous Cell Carcinoma: Examining Treatment Indications in Elderly Patients

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