Palliative external beam radiotherapy for the treatment of tumor bleeding in inoperable advanced gastric cancer.
Palliative external beam radiotherapy for the treatment of tumor bleeding in inoperable advanced gastric cancer.
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DOI：
10.1186/s12885-017-3508-x
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发表时间：
2017-08-12
期刊：
影响因子：
3.8
通讯作者：
Jang HS
中科院分区：
文献类型：
--
作者：
Lee YH;Lee JW;Jang HS
评估晚期胃癌患者姑息性外照射放射治疗（EBRT）的结局和预后因素。分析了42例接受EBRT姑息治疗的胃肿瘤出血患者。通过肿瘤出血的缓解来评估EBRT的反应。将患者分为EBRT应答者或非应答者。临床和剂量学变量的预后效用在多变量logistic回归模型中进行了研究。采用受试者工作特征分析确定两组患者的最佳剂量截断值。EBRT后29例（69.0%）胃肿瘤出血得到缓解。肿瘤出血消退的时间范围为1至84天（中位数为15天）。中位缓解时间为14.9周。EBRT剂量的中位数为40戈伊的反应者与21戈伊的无反应者，有显着差异（p < 0.001）。应答者的生物学有效剂量（使用α/β = 10，BED 10）显著高于非应答者的BED 10（中位数48戈伊vs. 26.4戈伊，p < 0.001），区分两组的最佳截止值为36戈伊（p < 0.001）。无远处转移和同时使用化疗通常显示更好的EBRT反应（分别为p = 0.079和p = 0.079）。在多变量分析中，BED 10 ≥ 36戈伊是与EBRT反应相关的最显著因素（p = 0.001）。总生存期（OS）和无再出血生存期的中位数分别为12.6周和14.9周。EBRT的应答者显示出上级的OS（16.6 vs. 5.1个月，p < 0.001）。未观察到3级或以上的急性或慢性毒性。EBRT是治疗进展期胃癌出血的有效方法，且无严重毒副作用。
To assess the outcomes and prognostic factors associated with palliative external beam radiotherapy (EBRT), administered to patients with advanced gastric cancer. Forty-two patients with bleeding gastric tumors that received EBRT for palliation were analyzed. The response to EBRT was assessed by the palliation of tumor bleeding. Patients were classified as either responders, or non-responders to EBRT. The prognostic utility of clinical and dosimetric variables was examined in a multivariate logistic regression model. The optimal dose cutoff to classify the two groups was determined with receiver operating characteristic analysis. The palliation of gastric tumor bleeding after EBRT was achieved in 29 patients (69.0%). The time to resolve tumor bleeding ranged from 1 to 84 days (median, 15 days). The median duration of palliation was 14.9 weeks. The median EBRT dose was 40 Gy in responders vs. 21 Gy in non-responders, with the difference being significant (p < 0.001). The biologically effective dose (using α/β = 10, BED10) for responders was significantly higher than the BED10 for non-responders (median 48 Gy vs. 26.4 Gy, p < 0.001), and the optimal cut off value to separate the two groups was 36 Gy (p < 0.001). The absence of distant metastasis and the use of concurrent chemotherapy generally showed a better EBRT response (p = 0.079 and p = 0.079, respectively). In the multivariate analysis, BED10 ≥ 36 Gy was the most significant factor associated with EBRT response (p = 0.001). Overall survival (OS) and re-bleeding-free survival was median 12.6 weeks and 14.9 weeks. The responders to EBRT showed superior OS (16.6 vs. 5.1 months, p < 0.001). Neither acute nor chronic toxicities of grade 3 or higher were observed. EBRT is an effective method for treating tumor bleeding in advanced gastric cancer, and does not induce severe toxicity.
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影响因子：
9.6
作者：
ALLUM, WH;BREARLEY, S;KEIGHLEY, MRB
通讯作者：
KEIGHLEY, MRB
影响因子：
1.9
作者：
Lee, Jung Ae;Lim, Do Hoon;Huh, Seung Jae
通讯作者：
Huh, Seung Jae
影响因子：
2.3
作者：
Lee JW;Lee JE
通讯作者：
Lee JE
DOI：
10.1016/j.ijrobp.2006.08.070
发表时间：
2007-02-01
影响因子：
7
作者：
Tey, Jeremy;Back, Michael F.;Zhu, Ming
通讯作者：
Zhu, Ming
影响因子：
4.6
作者：
Jung KW;Won YJ;Kong HJ;Oh CM;Cho H;Lee DH;Lee KH
通讯作者：
Lee KH