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Haemostatic radiotherapy for bleeding cancers of the upper gastrointestinal tract

Haemostatic radiotherapy for bleeding cancers of the upper gastrointestinal tract Bleeding can cause significant morbidity in patients with upper gastrointestinal malignancies. Palliative radiotherapy can palliate bleeding effectively across numerous cancer sites such as the lung and rectum. The data available regarding the role in bleeding from upper gastrointestinal cancers are limited to a single meta-analysis, a phase 2 trial, eleven retrospective cohorts and two case reports, with the majority focusing on gastric cancer. From the data available radiotherapy appears to be a well-tolerated, effective haemostatic agent that should be considered in all patients with bleeding from an upper gastrointestinal malignancy. Questions remain regarding the radiobiology of haemostasis and the optimum fractionation schedule. There is no convincing evidence that protracted higher dose regimens provide additional benefit. Commonly used fractionation schedules use 1, 5 or 10 fractions. Short fractionation schedules have been used in patients with deteriorating performance status. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png British Journal of Hospital Medicine Mark Allen Group

Haemostatic radiotherapy for bleeding cancers of the upper gastrointestinal tract

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References (25)

Publisher
Mark Allen Group
Copyright
Copyright © 2019 MA Healthcare Limited
ISSN
1750-8460
eISSN
1759-7390
DOI
10.12968/hmed.2019.80.10.579
Publisher site
See Article on Publisher Site

Abstract

Bleeding can cause significant morbidity in patients with upper gastrointestinal malignancies. Palliative radiotherapy can palliate bleeding effectively across numerous cancer sites such as the lung and rectum. The data available regarding the role in bleeding from upper gastrointestinal cancers are limited to a single meta-analysis, a phase 2 trial, eleven retrospective cohorts and two case reports, with the majority focusing on gastric cancer. From the data available radiotherapy appears to be a well-tolerated, effective haemostatic agent that should be considered in all patients with bleeding from an upper gastrointestinal malignancy. Questions remain regarding the radiobiology of haemostasis and the optimum fractionation schedule. There is no convincing evidence that protracted higher dose regimens provide additional benefit. Commonly used fractionation schedules use 1, 5 or 10 fractions. Short fractionation schedules have been used in patients with deteriorating performance status.

Journal

British Journal of Hospital MedicineMark Allen Group

Published: Oct 2, 2019

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