EFFICACY OF PALLIATIVE RADIOTHERAPY IN PATIENTS WITH GASTRIC CANCER

Introduction: Gastric cancer (GC) is the fourth most common neoplasm in men and the fifth most common in women worldwide. In Brazil, 20.520 new cases were estimated in 2016. Surgery is the primary treatment, however a significant portion of patients present with advanced disease and are not surgical candidates. Symptomatic gastric bleeding can occur in at least 10% of patients. Several studies report on the effectiveness of Radiotherapy (RT) in the palliation of GC bleeding. However, clear definitions of successful palliation are usually not stated. In addition, the duration of palliation is not reported. Objectives: To assess the efficacy of RT in Patients with gastric cancer submitted to palliative radiotherapy with hemostatic intent. Material and methods: We retrospectively reviewed the clinical data of all patients who received palliative RT for GC bleeding at our institution between 2010 and 2015. We included patients with biopsy proven GC that were not candidates for surgery due to unresectable or metastatic disease or clinical condition. Our primary endpoint was event- -free survival (EFS), defined as absence of new episode of bleeding, drop of hemoglobin > 2 points, need for blood transfusion or death from tumor bleeding. Secondary outcomes was overall survival. Results: We identified 122 patients who received palliative RT for GC bleeding. Median age was 64.6 years (range, 26 to 93), patients were predominantly male (70.5%).76.2% of patients had metastatic disease, with KPS>70 in 52%. Median event-free survival was 81 days. Median survival was 65 days. RT regimens ranged from 5 Gy in 1 fraction to 40 Gy in 16 fractions. Most patients (69%) were treated with a total of 20Gy in 5 fractions (BED 28Gy10). EFS was better in patients who received BED ≥ 28Gy10 (p=0.023).10.6% of patients were subsequently re-treated with palliative RT. Conclusions: In our analysis, median effective palliation lasted for 2.7 months. BED ≥ 28Gy10 is recommended to avoid new events and need for retreatment.

 

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Artikel online veröffentlicht:
10. Juli 2025