Title: Haemostatic Radiotherapy Dosing Schedules: A Review Article

Authors: Shashank Shenoy, Rajan Yadav, Ankita Parikh, Maitrik Mehta, U Suryanarayan

 DOI: https://dx.doi.org/10.18535/jmscr/v7i4.80

Abstract

Introduction

Approximately 10% of patients of advanced cancer present with bleeding. This can be a distressing sight alike for patient and care givers. in a country like ours, this presentation is of particular value as about 40% patients present with advanced stage. Bleeding can present in many ways including hematemesis, haematochezia, melena, hemoptysis, haematuria, epistaxis, vaginal bleeding or ulcerated skin lesions. a majority of them resolve by pharmacological measures and compression dressings, for those which don’t resolve radiotherapy can be used. In such situations radiotherapy (RT) has been used with great effect. This review focuses on radiotherapy when used with haemostatic intent. Generally haemostatic RT is believed to be an effective treatment for patients with bleeding due to cancer. Relatively little published literature is available which focuses on bleeding control of haemostatic RT and even less is known about the optimal RT total dose and fractionation.

Keywords: Haemostasis, Apoptosis, Radiotherapy

References

  1. Pereira and T. Phan, “Management of bleeding in patients with advanced cancer,” Oncologist, vol. 9, no. 5, pp. 561–570, 2004.
  2. Cihoric, S. Crowe, S. Eychm¨uller et al., “Clinically significant bleeding in incurable cancer patients: effectiveness of haemostatic radiotherapy,” Radiation Oncology, vol. 7, no. 1, p. 132, 2012.
  3. Asakura, T. Hashimoto, H. Harada et al., “Palliative radiotherapy for bleeding from advanced gastric cancer: is a schedule of 30Gy in 10 fractions adequate?” Journal of Cancer Research and Clinical Oncology, vol. 137, no. 1, pp. 125–130,2011.
  4. M. Biswal, “Hemostatic radiotherapy in carcinoma of the uterine cervix,” International Journal of Gynecology and Obstetrics, vol. 50, no. 3, pp. 281–285, 1995.
  5. A. Barnes, D. Breen, S. Culleton et al., “Palliative radiotherapy for non-melanoma skin cancer,” Clinical Oncology, vol. 22, no. 10, pp. 844–849, 2010.
  6. Jang, Helena Sung-In et al. “Radiotherapy can cause haemostasis in bleeding skin malignancies.” Case reports in medicine 2012 (2012)
  7. A. Langendijk, N. K. Aaronson, J. M. A. De Jong et al., “Prospective study on quality of life before and after radical radiotherapy in non-small-cell lung cancer,” Journal of ClinicalOncology, vol. 19, no. 8, pp. 2123–2133, 2001.
  8. Tey,M. F. Back, T. P. Shakespeare et al., “The role of palliative radiation therapy in symptomatic locally advanced gastric cancer,” International Journal of Radiation Oncology BiologyPhysics, vol. 67, no. 2, pp. 385–388, 2007.
  9. Hashimoto, H. Mayahara, A. Takashima et al., “Palliative radiation therapy for hemorrhage of unresectable gastric cancer: a single institute experience,” Journal of Cancer Research and Clinical Oncology, vol. 135, no. 8, pp. 1117–1123, 2009.
  10. A. Lee, D. H. Lim, W. Park, Y. C. Ahn, and S. J. Huh, “Radiation therapy for gastric cancer bleeding,” Tumori, vol. 95, no. 6, pp. 726–730, 2009.
  11. I. Koukourakis, “Tumour angiogenesis and response to radiotherapy,” Anticancer Research, vol. 21, no. 6, pp. 4285– 4300, 2001.
  12. Kempin, “Disorders of hemostasis in malignancy,” Current Problems in Cancer, vol. 4, no. 4, pp. 21–26, 1979
  13. Kraiphibul P, Srisupundit S, Kiatgumjakajom S, Pairachvet V. The experience in using whole pelvic irradiation in management of massive bleeding from carcinoma of the uterine cervix. J Med Assoc Thailand 1993; 76 Suppl 1: 78-81
  14. Gagnon, Bruno & Mancini, I & Pereira, J &Bruera, Eduardo. (1998). Palliative management of bleeding events in advanced cancer patients [Case report]. Journal of palliative care. 14. 50-4.

Corresponding Author

Shashank Shenoy

Department of Radiation Oncology, The Gujarat Cancer and Research Institute, Ahmedabad, Gujarat

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mob: +91-9900916167