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Title: The role of palliative radiation therapy in symptomatic locally advanced gastric cancer

Abstract

Purpose: To review the outcome of palliative radiotherapy (RT) alone in patients with symptomatic locally advanced or recurrent gastric cancer. Methods and Materials: Patients with symptomatic locally advanced or recurrent gastric cancer who were managed palliatively with RT at Cancer Institute, Singapore were retrospectively reviewed. Study end points included symptom response, median survival, and treatment toxicity (retrospectively scored using the Common Toxicity Criteria v3.0 [CTC]). Results: Between November 1999 and December 2004, 33 patients with locally advanced or recurrent gastric cancer were managed with palliative intent using RT alone. Median age was 76 years (range, 38-90 years). Twenty-one (64%) patients had known distant metastatic disease at time of treatment. Key index symptoms were bleeding (24 patients), obstruction (8 patients), and pain (8 patients). The majority of patients received 30 Gy/10 fractions (17 patients). Dose fractionation regimen ranged from an 8-Gy single fraction to 40 Gy in 16 fractions. Median survival was 145 days, actuarial 12-month survival 8%. A total of 54.3% of patients (13/24) with bleeding responded (median duration of response of 140 days), 25% of patients (2/8) with obstruction responded (median duration of response of 102 days), and 25% of patients (2/8) with pain responded (median duration of responsemore » of 105 days). No obvious dose-response was evident. One Grade 3 CTC equivalent toxicity was recorded. Conclusion: External beam RT alone is an effective and well tolerated modality in the local palliation of gastric cancer, with palliation lasting the majority of patients' lives.« less

Authors:
 [1];  [2];  [3];  [2];  [3];  [4];  [2];  [3];  [2];  [2];  [3];  [2];  [2];  [3];  [5]
  1. Department of Radiation Oncology, Cancer Institute, National University Hospital (Singapore) and Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital (Singapore). E-mail: Jeremy_Tey@mail.nhg.com.sg
  2. Department of Radiation Oncology, Cancer Institute, National University Hospital (Singapore)
  3. (Singapore)
  4. (Australia)
  5. Clinical Trials and Epidemiology Research Unit, Ministry of Health (Singapore)
Publication Date:
OSTI Identifier:
20944677
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2006.08.070; PII: S0360-3016(06)02833-1; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; FRACTIONATED IRRADIATION; METASTASES; PAIN; PATIENTS; RADIATION DOSES; RADIOTHERAPY; REVIEWS; SINGAPORE; STOMACH; TOXICITY

Citation Formats

Tey, Jeremy, Back, Michael F., Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, Shakespeare, Thomas P., Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, North Coast Cancer Institute, Port Macquarie, New South Wales, Mukherjee, Rahul K., Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, Lu, Jiade J., Lee, Khai Mun, Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, Wong, Lea Choung, Leong, Cheng Nang, Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, and Zhu Ming. The role of palliative radiation therapy in symptomatic locally advanced gastric cancer. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.08.070.
Tey, Jeremy, Back, Michael F., Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, Shakespeare, Thomas P., Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, North Coast Cancer Institute, Port Macquarie, New South Wales, Mukherjee, Rahul K., Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, Lu, Jiade J., Lee, Khai Mun, Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, Wong, Lea Choung, Leong, Cheng Nang, Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, & Zhu Ming. The role of palliative radiation therapy in symptomatic locally advanced gastric cancer. United States. doi:10.1016/j.ijrobp.2006.08.070.
Tey, Jeremy, Back, Michael F., Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, Shakespeare, Thomas P., Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, North Coast Cancer Institute, Port Macquarie, New South Wales, Mukherjee, Rahul K., Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, Lu, Jiade J., Lee, Khai Mun, Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, Wong, Lea Choung, Leong, Cheng Nang, Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital, and Zhu Ming. Thu . "The role of palliative radiation therapy in symptomatic locally advanced gastric cancer". United States. doi:10.1016/j.ijrobp.2006.08.070.
@article{osti_20944677,
title = {The role of palliative radiation therapy in symptomatic locally advanced gastric cancer},
author = {Tey, Jeremy and Back, Michael F. and Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital and Shakespeare, Thomas P. and Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital and North Coast Cancer Institute, Port Macquarie, New South Wales and Mukherjee, Rahul K. and Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital and Lu, Jiade J. and Lee, Khai Mun and Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital and Wong, Lea Choung and Leong, Cheng Nang and Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital and Zhu Ming},
abstractNote = {Purpose: To review the outcome of palliative radiotherapy (RT) alone in patients with symptomatic locally advanced or recurrent gastric cancer. Methods and Materials: Patients with symptomatic locally advanced or recurrent gastric cancer who were managed palliatively with RT at Cancer Institute, Singapore were retrospectively reviewed. Study end points included symptom response, median survival, and treatment toxicity (retrospectively scored using the Common Toxicity Criteria v3.0 [CTC]). Results: Between November 1999 and December 2004, 33 patients with locally advanced or recurrent gastric cancer were managed with palliative intent using RT alone. Median age was 76 years (range, 38-90 years). Twenty-one (64%) patients had known distant metastatic disease at time of treatment. Key index symptoms were bleeding (24 patients), obstruction (8 patients), and pain (8 patients). The majority of patients received 30 Gy/10 fractions (17 patients). Dose fractionation regimen ranged from an 8-Gy single fraction to 40 Gy in 16 fractions. Median survival was 145 days, actuarial 12-month survival 8%. A total of 54.3% of patients (13/24) with bleeding responded (median duration of response of 140 days), 25% of patients (2/8) with obstruction responded (median duration of response of 102 days), and 25% of patients (2/8) with pain responded (median duration of response of 105 days). No obvious dose-response was evident. One Grade 3 CTC equivalent toxicity was recorded. Conclusion: External beam RT alone is an effective and well tolerated modality in the local palliation of gastric cancer, with palliation lasting the majority of patients' lives.},
doi = {10.1016/j.ijrobp.2006.08.070},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 67,
place = {United States},
year = {Thu Feb 01 00:00:00 EST 2007},
month = {Thu Feb 01 00:00:00 EST 2007}
}