PMID- 32356453
OWN - NLM
STAT- MEDLINE
DCOM- 20200629
LR  - 20220415
IS  - 1748-880X (Electronic)
IS  - 0007-1285 (Print)
IS  - 0007-1285 (Linking)
VI  - 93
IP  - 1111
DP  - 2020 Jul
TI  - Hemostatic radiotherapy for inoperable gastric cancer: a pilot study.
PG  - 20190958
LID - 10.1259/bjr.20190958 [doi]
LID - 20190958
AB  - OBJECTIVE: Standard treatment for progressive gastric cancer with bleeding 
      includes hemostatic radiotherapy (RT); however, the only prospective study using 
      a fixed dose with fractions during hemostatic RT did not introduce 
      re-irradiation. Therefore, we determined the utility of RT including 
      re-irradiation for gastric cancer. METHODS: In this study, 31 patients with 
      gastric cancer and bleeding were treated with an initial dose of 20 Gy/5 
      fractions for the whole stomach and a salvage dose of 15 Gy/5 fractions for the 
      partial stomach. Patients achieving hemostasis, defined as a stable hemoglobin 
      level within 30 days following irradiation, were considered responders, whereas 
      those with no cessation of bleeding and those with re-bleeding within 30 days of 
      irradiation were considered non-responders. We evaluated response rate, 
      disease-free survival, overall survival (OS), re-irradiation, and adverse events 
      (AEs). RESULTS: The response rate of initial RT was 80% (25/31). 6 of the 25 
      patients underwent re-irradiation, and all 6 were responders (100%). The median 
      OS was significantly different among the entire cohort and one-time irradiation 
      and re-irradiation groups (91, 76, and 112 days, respectively). No AEs of grade 
      >/=3 were observed. Initial low-dose RT followed by reirradiation was effective in 
      reducing AEs and did not cause any further AEs. CONCLUSION: Hemostatic RT was an 
      effective approach with low toxicity, and re-irradiation was effective and 
      tolerable, with no patients developing severe AEs. Further, randomized controlled 
      studies are warranted to determine the ideal dose and number of fractions for 
      initial RT in patients with gastric cancer and bleeding. ADVANCES IN KNOWLEDGE: 
      In this prospective study on hemostatic radiotherapy for gastric cancer, the 
      response rate was 80% using a fixed dose of 20 Gy/5 fractions and the salvage 
      dose of 15 Gy for re-bleeding was effective. Future comparative studies should 
      include other doses with 20 Gy as a control.
FAU - Tanaka, Osamu
AU  - Tanaka O
AUID- ORCID: 0000-0002-7189-8407
AD  - Department of Radiation Oncology, Asahi University Hospital, Mizuho, Japan.
FAU - Sugiyama, Akihiko
AU  - Sugiyama A
AD  - Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan.
FAU - Omatsu, Tatsushi
AU  - Omatsu T
AD  - Department of Gastroenterology, Asahi University Hospital, Mizuho, Japan.
FAU - Tawada, Masahiro
AU  - Tawada M
AD  - Department of Surgery, Asahi University Hospital, Mizuho, Japan.
FAU - Makita, Chiyoko
AU  - Makita C
AD  - Department of Radiology, Gifu University Hospital, Gifu, Japan.
FAU - Matsuo, Masayuki
AU  - Matsuo M
AD  - Department of Radiology, Gifu University Hospital, Gifu, Japan.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20200511
PL  - England
TA  - Br J Radiol
JT  - The British journal of radiology
JID - 0373125
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Disease-Free Survival
MH  - Female
MH  - Gastrointestinal Hemorrhage/*radiotherapy
MH  - Hemostasis/physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Care Planning
MH  - Pilot Projects
MH  - Prospective Studies
MH  - Radiotherapy Dosage
MH  - Re-Irradiation/statistics & numerical data
MH  - Recurrence
MH  - Stomach Neoplasms/*radiotherapy
MH  - Treatment Outcome
PMC - PMC7336061
EDAT- 2020/05/02 06:00
MHDA- 2020/07/01 06:00
PMCR- 2021/07/01
CRDT- 2020/05/02 06:00
PHST- 2020/05/02 06:00 [pubmed]
PHST- 2020/07/01 06:00 [medline]
PHST- 2020/05/02 06:00 [entrez]
PHST- 2021/07/01 00:00 [pmc-release]
AID - 10.1259/bjr.20190958 [doi]
PST - ppublish
SO  - Br J Radiol. 2020 Jul;93(1111):20190958. doi: 10.1259/bjr.20190958. Epub 2020 May 
      11.