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.