Short-course palliative radiation therapy leads to excellent bleeding control: A single centre retrospective study

Abstract

HighlightsHemostatic radiotherapy is highly effective (89% bleeding control).Only 24% of the patients presenting with oncologic bleeding were alive after 1 year.Regimens with >5 fractions are associated with more definitive interruptions.

Palliative Radiation Therapy for Macroscopic Hematuria Caused by Urothelial Cancer

“…4,26 Several studies have suggested that shortcourse RT was as efficient as RT administered in a higher number of fractions or long-course RT for obtaining bleeding control. 3,5,6,27 In a previously conducted retrospective study, 20 Gy in 5 fractions (n = 46), 30 Gy in 10 fractions (n = 25), and 8 Gy in a single fraction (n = 21) were the most commonly used regimens in 112 patients who were receiving palliative RT for the control of MH occurring from tumors. 27 Both longer RT regimens (>5 fractions) and shorter regimens (£5 fractions) exerted equal hemostatic effect ( p = 0.497) for an equal duration ( p = 0.652).…”

“…3,5,6,27 In a previously conducted retrospective study, 20 Gy in 5 fractions (n = 46), 30 Gy in 10 fractions (n = 25), and 8 Gy in a single fraction (n = 21) were the most commonly used regimens in 112 patients who were receiving palliative RT for the control of MH occurring from tumors. 27 Both longer RT regimens (>5 fractions) and shorter regimens (£5 fractions) exerted equal hemostatic effect ( p = 0.497) for an equal duration ( p = 0.652). However, longer regimens caused frequent treatment interruptions and increased hospital days (22.2% vs. 5.3%, p = 0.020).…”

Patterns of practice in palliative radiotherapy for bleeding tumours in the Netherlands; a survey study among radiation oncologists

“…In the group of patients receiving a BED ≥ 39 Gy 7 out of 17 responded and in the group receiving a BED < 39 Gy 6 out of 7 showed a response (p = NS) [24] . In a recent publication of Sapienza et al , the authors describe the results of a single center study with a large group of patients [18] . In this cohort of 112 patients, bleeding control information was available for 100 patients.…”

“…There is substantial evidence that palliative radiotherapy (RT) is effective in the management of bleeding, with reported treatment response (i.e. that bleeding would stop or diminish) varying from 45% to 100% [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] . It is, however, not clear which RT schedule, with regard to fractionation and total dose, is most ‘optimal’ (with as less fractions and less toxicity for the patient and as much as possible effect on symptom control) to manage bleeding.…”

“…pain or obstruction) and the aim to reduce tumour volume can influence the chosen fractionation and total dose. Therefore, RT schedules described in literature vary considerably between studies (total dose ranged from 5 to 76 Gray {Gy}, number of fractions ranged from 1 to 39), consisting of only a few randomized controlled trials (RCTs) that compared different RT schedules, mainly with limited numbers of patients [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [16] , [17] , [18] , [20] , [22] , [23] . Table 1 summarizes the main studies on palliative radiotherapy in the management of bleeding using external beam radiotherapy (randomized and retrospective studies including information with regard to bleeding of at least 30 patients) that provide information with regard to fractionation schemes used, the bleeding control rate and/or duration of bleeding control.…”