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DOI: 10.1055/s-0044-1798159
PALIATIVE RADIOTHERAPY FOR GASTRIC CANCER: IS THERE A RELATIONSHIP BETWEEN DOSE AND BLEEDING STOP?
Authors
Objective: To evaluate if there is a relationship between radiotherapy dose and response to bleeding in palliative patients with local relapse or disease progression in gastric cancer. Methodology: It was conducted a systematic meta-analysis review of observational studies evaluating bleeding response in a gastric cancer (GC) patient with local relapse or disease progression. A meta-regression was performed between biological effective dose (BED) and complete bleeding response (CBR). A subgroup analysis was performed stratifying studies by BED level and radiotherapy technique (RT). A value of p <0.05 was significant. Results: Ten noncomparative retrospective studies and one prospective study were included. Overall, RT was an effective treatment for CBR, the CBR rate was 0.77 (95% CI 0.73- 0.81). The meta-regression showed a linear relationship between BED Gy 10 and CBR (p = 0 <0001). Studies using conformational RT obtained a significant difference in the rate of CBR when compared to RT2D (0.79 CI95% 0.74 -0.84 vs 0.65 CI95% 0.56 - 0.75, p = 0.021). In subgroup analysis dividing the studies into 3 levels of BED and assessing the CBR rate, a higher response was obtained in studies with BED> = 30Gy10; BED Gy 10 ≥40 (0.79 CI95% 0.7-0.8), BED Gy10 30-39 (0.79 CI95% 0.71- 0.86) and BED Gy10 <30 (0.64 CI95% 0.5-0.7, p = 0.0001). The median survival was 3.31 months (95% CI 2.73 - 3.9), and response to treatment had a significant increase in survival compared to non-response 2.5 months (95% CI 1.7 - 3.3, p <0.0001). Conclusion: Palliative RT is effective in controlling bleeding by local control / local progression of gastric cancer. There is a relationship between CBR and BED. Our data show that BED <30Gy 10 should not be recommended, and for best results the 3D technique should be indicated.
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Artikel online veröffentlicht:
23. Oktober 2019
© 2019. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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Gustavo Viani Arruda, Anielle Freitas Bendo Danelichen, Leonardo Vicente Fay Neves, Ana Carolina Hamamura, Alexandre Faustino Ciuffi, Fernando Kojo Matsuura. PALIATIVE RADIOTHERAPY FOR GASTRIC CANCER: IS THERE A RELATIONSHIP BETWEEN DOSE AND BLEEDING STOP?. Brazilian Journal of Oncology 2019; 15.
DOI: 10.1055/s-0044-1798159