Hüseyin Furkan ÖZTÜRK, Gonca ALTINIŞIK İNAN, İpek Pınar ARAL, Suheyla AYTAÇ ARSLAN, Sedef GÖKHAN AÇIKGÖZ, Havva BEYAZ, Yılmaz TEZCAN

Üç boyutlu konformal palyatif mide radyoterapisi uygulanan hastalarda klinik sonuçlar: tek merkez deneyimi

Giriş: Lokal ileri ve/veya metastatik mide kanseri teşhisi konulan ve ameliyat edilemeyen hastaların takipleri sırasında palyatif tedaviye ihtiyaç duyulabilir. Bu çalışmada non-invaziv bir yöntem olarak palyatif eksternal 3-D mide radyoterapisinin, onkolojik sonuçlara etkisini araştırmak amaçlanmıştır Gereç ve Yöntem 2013-2017 yılları arasında kliniğimizde palyatif eksternal radyoterapi (RT) ile tedavi edilen 16 mide kanseri hastası değerlendirildi. Yalnızca tıkanıklık, ağrı ve kanama nedeniyle palyatif mide radyoterapisi alan hastalar analize dahil edildi ve daha önce abdomen bölgesine RT uygulanan veya adjuvan amaçlı RT verilen hastalar analize dahil edilmedi. Bulgular Tüm hastalar incelendiğinde, 7 hastanın, (%43) planlanan palyatif radyoterapisini tamamlayamadığı bulundu. 10 fraksiyonlu 30 Gy palyatif şema, en çok planlanan RT programıydı ve hastaların yaklaşık yarısı (%56) RT öncesinde kemoterapi almıştı. Genel sağ kalım tüm kohortta medyan 2 ay olarak hesaplandı. Ortalama sağkalım 28 Gy biyoeşdeğer doz alabilen hastalarda daha iyiydi (4'e 0,3 ay, p≤0,00). Palyasyonun amacı da, sağkalıma etki eden bir faktör olarak bulundu. Ağrı nedeniyle RT uygulanan hastaların, kanama ve obstrüksiyon nedeniyle RT uygulananlardan daha iyi sağ kalıma sahip olduğu bulundu (13'e karşı 0.7 ay, p=0.03). Sonuç Eksternal 3-D radyoterapi, mide kanserli hastalarda palyasyon için kolay uygulanabilir ve etkili bir yöntemdir. Palyasyon ihtiyacı olan hastalarda radyoterapiye erken sevk edilmesi onkolojik sonuçları artırabilir. Mide kanaması ve tıkanıklığı nedenyile palyatif radyoterapi uygulanan hastalarda prognozun daha kötü seyrettiği gözlenmiştir.

Anahtar Kelimeler:

Mide Kanseri, Radyoterapi, Gastrointestinal Kanama

Clinical outcomes of palliative 3-dimensional conformal external beam gastric radiotherapy: single center experience

Aim: Patients diagnosed with locally advanced and/or metastatic gastric cancer and who cannot undergo surgery may need palliative treatment during their follow-up. There is scarce data about outcomes of palliative gastric radiotherapy (RT). In this study, we aimed to investigate the effect of 3-D external beam RT on oncological outcomes, as a non-invasive method.Material and Method: From 2013 to 2017, sixteen gastric cancer patients treated with palliative external RT in our institutional clinic were evaluated. Only patients who received palliative gastric radiotherapy for obstruction, pain and bleeding were analyzed, and patients who had previously received RT to the abdomen or who were given RT for adjuvant purposes were not included in the analysis. Results: Seven patients (43%) were not able to finish the planned palliative course. Thirty Gray with 10 fractions was the most planned RT schedule. Almost half of the patients (%56) received chemotherapy before RT. Overall survival was found to be median 2 months. Median survival was better in patients who were able to receive 28 Gy bioequivalent dose (4 vs 0.3 months, p≤0.00). Purpose of palliation also found to be a significant factor on survival. Patients who were referred for pain have found to be better survival rather than bleeding and obstruction (13 vs 0.7 months, p=0.03).Conclusion: External radiotherapy is an easily applicable and effective method for palliation in gastric cancer patients. Early referral for radiotherapy in patients who need palliation may increase oncological outcomes. It has been observed that the prognosis is worse in patients who received palliative radiotherapy due to gastric bleeding and obstruction.

Keywords:

Gastric Cancer, Radiotherapy, Gastrointestinal Hemorrhage,

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