Palliative Radiotherapy for Bleeding from Unresectable Gastric Cancer Using Three-Dimensional Conformal Technique

Kawabata, Hideaki; Fujii, Takashi; Yamamoto, Tetsuya; Satake, Hiroaki; Yamaguchi, Katsutoshi; Okazaki, Yuji; Nakase, Kojiro; Miyata, Mariko; Motoi, Shigehiro

doi:10.3390/biomedicines10061394

Cited by 5 publications

(4 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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%

“…In contrast, Kawamoto et al focused solely on symptoms as a primary outcome and demonstrated that shortness of breath, pain, and distress improved after radiotherapy (30). At least two studies reported on the use of repeat radiotherapy doses in an attempt to control rebleeding (19,31). In one of these studies (31), two patients were re-irradiated for hemostasis, and, unfortunately, gastrointestinal perforation occurred in both patients.…”

Section: Radiationmentioning

confidence: 99%

See 1 more Smart Citation

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

Kopecky¹,

Monton²,

Rosman³

et al. 2022

Chin Clin Oncol

View full text Add to dashboard Cite

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.

show abstract

Section: Radiationmentioning

confidence: 99%

Section: Radiationmentioning

confidence: 99%

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

Kopecky¹,

Monton²,

Rosman³

et al. 2022

Chin Clin Oncol

View full text Add to dashboard Cite

show abstract

“…However, there is no unified consensus on its specific efficacy, and further evidence needs to be accumulated to clarify the objective response rate. The effectiveness of palliative radiation therapy for gastric cancer has been recently reported as follows: Kawabata et al treated 20 patients with unresectable gastric cancer with 3D-CRT [9]. There was a significant increase in the mean serum hemoglobin level (from 8.0 to 9.8, p = 0.01).…”

Section: Discussionmentioning

confidence: 98%

The Impact of Palliative Radiation Therapy on Patients With Advanced Gastric Cancer: Results of a Retrospective Cohort Study

Katano¹,

Yamashita²

2022

Cureus

View full text Add to dashboard Cite

In advanced gastric cancer, symptoms such as loss of appetite, stomach tightness, occasional pain, vomiting blood, and melena may occur. Palliative radiation therapy may be indicated in such cases. This study aimed to investigate the clinical outcomes of palliative radiotherapy in patients with advanced-stage gastric carcinoma. MethodsFrom April 2018 to October 2022, consecutive patients with non-resected advanced gastric cancer who received radiation therapy for palliation of symptoms were included. ResultsA total of 23 patients with advanced-stage gastric carcinoma were analyzed in this study. Twelve male and 11 female patients were included. The median overall survival period was 3.9 months (95% confidence interval: 1.0-8.7 months). Sixteen patients required erythrocyte transfusion before radiotherapy; for 13 patients (83%), the required units of erythrocyte transfusion decreased after palliative radiotherapy. The mean erythrocyte transfusion units significantly decreased from 4.2 (standard deviation [SD]: 4.3) to 1.7 (SD: 3.6) (p = 0.02). No adverse events of grade ≥3 were observed in this study population. ConclusionPalliative radiation therapy for advanced gastric cancer yielded a good response rate and can be a useful treatment option.

show abstract

“…The doses are often much lower, typically 30 Gy in 10 fractions or 20 Gy in 5 fractions [31]. Examples are irradiation of bone metastases for analgesic purposes [32], whole brain irradiation when patients have brain metastases and a risk of intracranial hypertension [33,34], mediastinal irradiation when patients have compressive mediastinal tumors [35], and irradiation for hemostatic purposes when patients have very hemorrhagic tumors [36]. Most of these indications are not urgent.…”

Section: Irradiation With Palliative Intentmentioning

confidence: 99%

A Comprehensive Primer on Radiation Oncology for Non-Radiation Oncologists

Beddok,

Lim,

Thariat

et al. 2023

Cancers

View full text Add to dashboard Cite

Background: Multidisciplinary management is crucial in cancer diagnosis and treatment. Multidisciplinary teams include specialists in surgery, medical therapies, and radiation therapy (RT), each playing unique roles in oncology care. One significant aspect is RT, guided by radiation oncologists (ROs). This paper serves as a detailed primer for non-oncologists, medical students, or non-clinical investigators, educating them on contemporary RT practices. Methods: This report follows the process of RT planning and execution. Starting from the decision-making in multidisciplinary teams to the completion of RT and subsequent patient follow-up, it aims to offer non-oncologists an understanding of the RO’s work in a comprehensive manner. Results: The first step in RT is a planning session that includes obtaining a CT scan of the area to be treated, known as the CT simulation. The patients are imaged in the exact position in which they will receive treatment. The second step, which is the primary source of uncertainty, involves the delineation of treatment targets and organs at risk (OAR). The objective is to ensure precise irradiation of the target volume while sparing the OARs as much as possible. Various radiation modalities, such as external beam therapy with electrons, photons, or particles (including protons and carbon ions), as well as brachytherapy, are utilized. Within these modalities, several techniques, such as three-dimensional conformal RT, intensity-modulated RT, volumetric modulated arc therapy, scattering beam proton therapy, and intensity-modulated proton therapy, are employed to achieve optimal treatment outcomes. The RT plan development is an iterative process involving medical physicists, dosimetrists, and ROs. The complexity and time required vary, ranging from an hour to a week. Once approved, RT begins, with image-guided RT being standard practice for patient alignment. The RO manages acute toxicities during treatment and prepares a summary upon completion. There is a considerable variance in practices, with some ROs offering lifelong follow-up and managing potential late effects of treatment. Conclusions: Comprehension of RT clinical effects by non-oncologists providers significantly elevates long-term patient care quality. Hence, educating non-oncologists enhances care for RT patients, underlining this report’s importance.

show abstract

Palliative Radiotherapy for Bleeding from Unresectable Gastric Cancer Using Three-Dimensional Conformal Technique

Cited by 5 publications

References 28 publications

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

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

The Impact of Palliative Radiation Therapy on Patients With Advanced Gastric Cancer: Results of a Retrospective Cohort Study

A Comprehensive Primer on Radiation Oncology for Non-Radiation Oncologists

Contact Info

Product

Resources

About