1 | INTRODUCTION
Advanced gastric cancer induces various symptoms, such as bleeding, anorexia, obstruction, and pain. In particular, bleeding from gastric cancer not only compromises the quality of life but also results in a life-threatening condition (1).
Palliative treatment options for bleeding from advanced gastric cancer include surgery, endoscopic hemostasis, transcatheter embolotherapy, and radiation therapy (RT) (1). Surgery is an effective treatment for bleeding from gastric cancer; however, it is eligible only for patients with a good performance status (PS) (2). Conversely, endoscopic hemostasis, transcatheter embolotherapy, and RT can be administered even to inoperable patients.
The rate of successful hemostasis by endoscopic treatment and that by embolotherapy is reported to be 31%–100% (3–5) and 40%–100% (1), respectively. Hemostatic RT is not used as commonly as those treatments (6). There have been several studies reporting the efficacy of RT on hemostasis as being approximately 50%–80% (1). However, the dose and fractionation have varied widely among studies, ranging from 8 Gy in 1 fraction to 60 Gy in 30 fractions, making the efficacy of this treatment obscure. In the clinical setting, the most commonly used dose-fractionation includes 20 Gy in 5 fractions and 30 Gy in 10 fractions.
We retrospectively analyzed the efficacy of palliative RT on hemostasis in seven patients with unresectable gastric cancer treated using dose-fractionations.