What is your general approach to treating bleeding gastric masses with palliative RT?

We once had a patient with stage IV NHL who had transfusion-dependent bleeding from a pesky gastric mass that was chemo-resistant. It turned into a fatal complication, so it was presented as an educational case at ASTRO. We gave 4 Gy x 1 which stopped the bleeding within 24h, and switched to 3 Gy x ...

In my experience, I have often used 300 cGy x 10 if carcinoma type tumor, but lower daily dose (200-250 cGy) if lymphatous type tumor.

Again -> I now try to always consider "Goals of Care" issues like... the extent of cancer/extent of repeated transfusions/patients' performance status/life expectancy...

Although I've never seen a gastric perforation, even in the extensive preoperative chemoradiation experience from M.D. Anderson, I agree with the comments above. I usually give 30 Gy in 10 fx to a generously contoured GTV with a 15 mm PTV margin.

Sometimes bleeding happens in patients with localized...