Radiation therapy for gastric cancer bleeding
Radiation therapy for gastric cancer bleeding
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DOI：
10.1177/030089160909500615
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发表时间：
2009-11-01
期刊：
影响因子：
1.9
通讯作者：
Huh, Seung Jae
中科院分区：
文献类型：
--
作者：
Lee, Jung Ae;Lim, Do Hoon;Huh, Seung Jae
目的和背景。目的评价姑息性放射治疗(RT)治疗胃癌大出血的疗效。对30例胃癌出血患者行姑息性放疗的临床资料进行了回顾性分析。23名患者接受了~gt；=30Gy10次/次的治疗。从主观和客观两方面评价姑息疗效。判断出血的主观症状缓解情况，并通过检测RT前后患者输注的红细胞(PRBC)数量和平均血红蛋白(Hb)水平来评估客观反应。观察21例患者主观症状缓解。放疗前一个月输血PRBC数为2~25个(中位数6个)，放疗后一个月为0~16个(中位数6个)(P<；0.001)。平均Hb水平由9.1+/-1.6g/dL上升至10.6+/-1.6g/dL(P<；0.001)。9例放疗后<3个月的患者，放疗后1个月、2个月和3个月的平均Hb分别为10.7±1.7g/dL(P=0.004)、10.5±1.0g/dL(P=0.039)和9.9±1.0g/dL(P=0.164)。移植后3个月，输注PRBC的中位数由6个降至0个。在其他方法不可行的情况下，RT可能是治疗胃癌出血的有效方法。在这项研究中，91%的患者在放疗后症状缓解，Hb水平升高，输血次数减少。
Aims and background. To evaluate the outcome of palliative radiotherapy (RT) for patients with gastric cancer bleeding.Methods. A retrospective review of 30 patients with gastric cancer bleeding who underwent palliative RT was conducted. Twenty-three patients who received a dose of >= 30 Gy in 10 fractions were eligible. The palliative effect was evaluated both in a subjective and objective manner. Subjective symptomatic relief of bleeding was determined and an objective response was evaluated by identifying the amount of transfused packed red blood cells (PRBC) and the mean hemoglobin (Hb) level of patients before and after RT.Results. Subjective symptom relief was observed in 21 patients. The number of transfused PRBC units was 2 to 25 (median, 6) during the month before RT and 0 to 16 (median, 6) during the month after RT (P < 0.001). The average level of Hb increased from 9.1 +/- 1.6 g/dL to 10.6 +/- 1.6 g/dL (P < 0.001). In 9 patients whose laboratory findings were available for >= 3 months after RT, the mean Hb at one, two, and three months after RT was 10.7 +/- 1.7 g/dL (P = 0.004), 10.5 +/- 1.0 g/dL (P= 0.039), and 9.9 +/- 1.0 g/dL (P = 0.164), respectively. The median number of transfused PRBC units decreased from 6 to 0 during the three months after RT.Conclusion. RT may be an effective treatment for gastric cancer bleeding when other modalities are not feasible. In this study, 91% of the patients experienced symptomatic palliation with an elevated Hb level and a decreased number of transfusions after RT.