Palliative radiotherapy shows benefit in gastric cancer

  • Tey J & al.
  • Cancer Med
  • 20 Feb 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • In patients with symptomatic, locally advanced gastric cancer, palliative radiotherapy improved symptoms of bleeding, pain, and blockage.
  • This is the first prospective study of palliative radiotherapy in locally advanced gastric cancer.

Why this matters

  • A range of interventions have been introduced to manage symptoms in this patient population, but radiotherapy is among the least invasive. It has been shown to be effective for bleeding and obstructive symptoms in advanced lung and bladder cancer.

Study design

  • Single-group, phase 2 trial (n=50; median age, 75 years).
  • Funding: None disclosed.

Key results

  • 74% of patients had a known distant metastasis.
  • Median survival, 83 days.
  • 40 (80%) of 50 patients experienced improvement in bleeding, defined as no further blood transfusion needed and no further melena episode at completion of radiotherapy. Median response duration, 102 (range, 2-1031) days.
  • Of 10 patients whose bleeding did not improve, 6 died before end of treatment.
  • 1/1 patients experienced improvement in pain.
  • 2/2 patients experienced relief from obstruction.
  • At the end of treatment, 50% of patients had improvement in fatigue, 28% in nausea/vomiting, and 44% in pain (measured by EORTC QoL Questionnaire C30).

Limitations

  • No control patients.
  • Small study.

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