Role of palliative radiotherapy in bleeding control in patients with unresectable advanced gastric cancer.
Role of palliative radiotherapy in bleeding control in patients with unresectable advanced gastric cancer.
复制标题
姑息性放疗在不可切除的晚期胃癌患者出血控制中的作用。
DOI：
10.1186/s12885-021-08145-4
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发表时间：
2021-04-15
期刊：
影响因子：
3.8
通讯作者：
Yoon SM
中科院分区：
文献类型：
--
作者：
Yu J;Jung J;Park SR;Ryu MH;Park JH;Kim JH;Yoon SM
本研究分析了姑息性放疗用于无法切除的晚期胃癌患者止血的临床效果。
我们回顾性查阅了2002年1月至2018年6月期间符合以下纳入标准患者的病历：经组织学确诊为胃癌，经上消化道内镜检查证实存在胃肿瘤出血，且接受姑息性放疗以止血。放疗的中位剂量为30戈瑞，每日剂量为1.8至3戈瑞。
本分析共纳入61例患者。研究人群以男性为主（72.1%），中位年龄为62岁（范围：32至92岁）。基线血红蛋白中位水平为7.1克/分升，胃肿瘤出血最常见的症状是黑便（85.2%）。54例（88.5%）患者实现了出血控制。放疗结束后1个月、2个月和3个月时血红蛋白的中位水平分别为10.1克/分升、10.2克/分升和10.4克/分升；这些数值与放疗前（7.1克/分升）相比有显著差异（p < 0.001）。中位总生存期为4.8个月。在放疗后实现出血控制的54例患者中，19例（35.2%）在随访期间出现再次出血。再次出血的中位时间为6.0个月。多变量分析表明，较高的放疗剂量（p = 0.007）和放疗后追加化疗（p = 0.004）是延长再次出血时间的重要因素。
对于无法切除的晚期胃癌患者，放疗能有效控制肿瘤出血。
This study analyzed the clinical results of palliative radiotherapy for bleeding control in patients with unresectable advanced gastric cancer. We retrospectively reviewed the medical records of patients who met the following inclusion criteria between January 2002 and June 2018: histologically proven gastric cancer, gastric tumor bleeding confirmed by upper gastrointestinal endoscopy, and palliative radiotherapy performed for hemostasis. The median radiotherapy dose was 30 Gy, with a daily dose ranging from 1.8 to 3 Gy. Sixty-one patients were included in this analysis. The study population was predominantly male (72.1%), with a median age of 62 years (range: 32–92). The median baseline hemoglobin level was 7.1 g/dL, and the most common presenting symptom of gastric tumor bleeding was melena (85.2%). Bleeding control was achieved in 54 (88.5%) patients. The median levels of hemoglobin at 1, 2, and 3 months after completion of radiotherapy were 10.1 g/dL, 10.2 g/dL, and 10.4 g/dL, respectively; these values were significantly different from that before radiotherapy (7.1 g/dL; p < 0.001). The median overall survival was 4.8 months. Among the 54 patients who achieved bleeding control after radiotherapy, 19 (35.2%) experienced re-bleeding during the follow-up period. The median time to re-bleeding was 6.0 months. Multivariate analysis demonstrated that a higher radiation dose (p = 0.007) and additional chemotherapy after radiotherapy (p = 0.004) were significant factors for prolonging the time to re-bleeding. Tumor bleeding was adequately controlled by radiotherapy in patients with unresectable advanced gastric cancer.
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