Efficacy of palliative radiotherapy and chemo-radiotherapy for unresectable gastric cancer demonstrating bleeding and obstruction

BackgroundBleeding and obstruction are common localized symptoms in patients with unresectable gastric cancer. Although there are several reports about surgical and endoscopic therapies for gastric cancer, there are few regarding palliative radiation therapy.MethodsWe retrospectively analyzed data for 23 gastric cancer patients who underwent palliative radiation between April 2006 and March 2014, with either localized bleeding (n=18) or upper gastric obstruction (n=10).ResultsThe median (range) total dose and fraction (Fr) of radiotherapy (RT) were 42 (18-60)Gy and 20 (9-30)Fr, respectively. The response rates were 88.8% (bleeding) and 80% (obstruction). The median event-free survival times of the bleeding and obstruction groups from the start of radiation were 103 and 104days, respectively. Adverse events with RT and chemo-radiotherapy (CRT) were grade 2 nausea (n=4) and grade 2 esophagitis (n=3) and grade 2 neutropenia (n=3). In univariate analysis, the antrum as the gastric primary site (p=0.063) and peritoneal metastasis (p=0.054) occurred more frequently in the non-responders (n=4) than the responders (n=19).