Haemostatic radiotherapy for bleeding cancers of the upper gastrointestinal tract.
Haemostatic radiotherapy for bleeding cancers of the upper gastrointestinal tract.
复制标题
止血放射治疗用于上消化道出血性癌症。
DOI：
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发表时间：
2019
影响因子：
0.9
通讯作者：
G. Radhakrishna
中科院分区：
文献类型：
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作者：
C. Hughes;G. Radhakrishna
出血可导致上消化道恶性肿瘤患者显着发病。姑息性放射治疗可以有效地缓解肺部和直肠等许多癌症部位的出血。关于上消化道癌出血的作用的可用数据仅限于一项荟萃分析、一项 2 期试验、11 个回顾性队列和两个病例报告，其中大多数集中于胃癌。从现有数据来看，放疗似乎是一种耐受性良好、有效的止血剂，所有上消化道恶性肿瘤出血患者都应考虑放疗。关于止血的放射生物学和最佳分馏方案仍然存在问题。没有令人信服的证据表明长期较高剂量的治疗方案可以提供额外的益处。常用的分馏方案使用 1、5 或 10 份馏分。短分割方案已用于体能状态恶化的患者。
Bleeding can cause significant morbidity in patients with upper gastrointestinal malignancies. Palliative radiotherapy can palliate bleeding effectively across numerous cancer sites such as the lung and rectum. The data available regarding the role in bleeding from upper gastrointestinal cancers are limited to a single meta-analysis, a phase 2 trial, eleven retrospective cohorts and two case reports, with the majority focusing on gastric cancer. From the data available radiotherapy appears to be a well-tolerated, effective haemostatic agent that should be considered in all patients with bleeding from an upper gastrointestinal malignancy. Questions remain regarding the radiobiology of haemostasis and the optimum fractionation schedule. There is no convincing evidence that protracted higher dose regimens provide additional benefit. Commonly used fractionation schedules use 1, 5 or 10 fractions. Short fractionation schedules have been used in patients with deteriorating performance status.