Abstract
Background
Bleeding and obstruction are common localized symptoms in patients with unresectable gastric cancer. Although there are several reports about surgical and endoscopic therapies for gastric cancer, there are few regarding palliative radiation therapy.
Methods
We retrospectively analyzed data for 23 gastric cancer patients who underwent palliative radiation between April 2006 and March 2014, with either localized bleeding (n = 18) or upper gastric obstruction (n = 10).
Results
The median (range) total dose and fraction (Fr) of radiotherapy (RT) were 42 (18–60) Gy and 20 (9–30) Fr, respectively. The response rates were 88.8% (bleeding) and 80% (obstruction). The median event-free survival times of the bleeding and obstruction groups from the start of radiation were 103 and 104 days, respectively. Adverse events with RT and chemo-radiotherapy (CRT) were grade 2 nausea (n = 4) and grade 2 esophagitis (n = 3) and grade 2 neutropenia (n = 3). In univariate analysis, the antrum as the gastric primary site (p = 0.063) and peritoneal metastasis (p = 0.054) occurred more frequently in the non-responders (n = 4) than the responders (n = 19).
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References
Katanoda K, Sobue T, Tanaka H, Miyashiro I (eds) (2016) JACR Monograph Supplement No. 2. Japanese Association of Cancer Registries, Tokyo
Vital Statistics Japan in 2015. Ministry of Health, Labour and Welfare
Ekbom GA, Gleysteen JJ (1980) Gastric malignancy: resection for palliation. Surgery 88:476–481
Lim S, Muhs BE, Marcus SG et al (2007) Results following resection for stage IV gastric cancer; are better outcomes observed in selected patient subgroups? J Surg Oncol 95:118–122
Monson JR, Donohue JH, McIlrath DC et al (1991) Total gastrectomy for advanced cancer. A worthwhile palliative procedure. Cancer 68:1863–1868
Savides TJ, Jensen DM. Jensen DM et al. Severe upper gastrointestinal tumor bleeding: endoscopic findings, treatment and outcome. Endoscopy 28:244–248
Loftus EV, Alexander GL, Ahlquist DA et al. Endosopic treatment of major bleeding from advanced gastroduodenal malignant lesions. Mayo Clin Proc 69:736–740
Mantel BS et al (1982) Radiotherapy for dysphagia due to gastric carcinoma. Br J Surg 69:69–70
Kim MM, Rana V, Janijan NA et al (2007) Clinical benefit of palliative radiation therapy in advanced gastric cancer. Acta Oncol 47:421–427
Tey J, Back MF, Shakespeare TP et al (2007) The role of palliative radiation therapy in symptomatic locally advanced gastric cancer. Int J Raadiat Oncol Biol Phys 67:385–388
Hashimoto K, Mhayahara H, Takashima A et al (2009) Palliative therapy for hemorrhage of unresectable gastric cancer. J Cancer Res ClinOncol 123:1117–1123
Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655
Japanese Gastric Cancer Association (2011) Japanese classification of gastric carcinoma: 3rd English edition Gastric Cancer. Gastric Cancer 14:101–112
Common Terminology Criteria for Adverse Events v3.0 publish date: August 9, 2006, Cancer Therapy Evaluation Program in National Cancer Institute
TNM Classification of Malignant Tumors 7th edition in union for international cancer control
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All the authors have approved the submission of this manuscript to your journal. There are no conflicts of interest to declare. We agree to allow the journal to review our data if requested.
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Hiramoto, S., Kikuchi, A., Tetsuso, H. et al. Efficacy of palliative radiotherapy and chemo-radiotherapy for unresectable gastric cancer demonstrating bleeding and obstruction. Int J Clin Oncol 23, 1090–1094 (2018). https://doi.org/10.1007/s10147-018-1317-0
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DOI: https://doi.org/10.1007/s10147-018-1317-0