A case of unresectable advanced gastric cancer treated with palliative radiation therapy twice for the purpose of hemostasis
10.2512/jspm.8.538
- VernacularTitle:止血目的に緩和的放射線治療を2度施行した切除不能進行胃がんの1例
- Author:
Masayuki Nakanowatari
;
Suzuko Ozaki
;
Takashi Fukuhara
;
Michio Iida
;
Jiro Honma
;
Yuhei Otoguro
;
Keishiro Suzuki
- Publication Type:Journal Article
- Keywords:
gastric cancer;
bleeding;
palliation;
radiation therapy;
hemostasis
- From:Palliative Care Research
2013;8(2):538-543
- CountryJapan
- Language:Japanese
-
Abstract:
Case: We report the case of a female in her sixties with inoperable gastric cancer in which continuous bleeding from the cancer resulted in severe anemia and the need for frequent repetitive blood transfusions. In order to control the hemorrhage, radiation therapy of 30 Gy/10 fractions to the cancer was conducted. Her tarry stool soon stopped, her hemoglobin level increased and transfusion became unnecessary. One month later, gastric rebleeding derived from the marginal area of the radiation field occurred. Additional radiation therapy of 24 Gy/8 fractions was given and successful hemostasis was obtained. The patient has been well without transfusion for four months. Conclusion: It is difficult to control bleeding from advanced gastric cancer if the tumor cannot be resected. Endoscopic hemostasis is not always applicable. Interventional radiotherapy (IVR) can be indicated for arterial bleeding. However, the indication of this treatment is controversial in cases of continuous venous bleeding, as seen in our case. Successful hemostasis by radiation therapy was obtained without severe complications in our case. Therefore, it is conceivable that radiation therapy to resistant venous bleeding from unresectable advanced gastric cancer upon careful consideration of complications is a useful treatment modality.
