Topics:
Radiation Oncology • Gastrointestinal Cancers
What is your general approach to treating bleeding gastric masses with palliative RT?
Do you have any preferred dose fractionation schedules? What kind of margins do you use?
Answer from: Radiation Oncologist at Community Practice
We once had a pt 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 9 to ...
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Answer from: Radiation Oncologist at Community Practice
In my experience, I have often used 300cGy x 10 if carcinoma type tumor, but lower daily dose (200-250cGy) if lymphatous type tumor.Again -> I now try to always consider "Goals of Care" issues like... extent of cancer / extent of repeated transfusions/ patients' performance status / life expectan...
Answer from: Radiation Oncologist at Academic Institution
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 30Gy in 10fx to a generously contoured GTV with a 15 mm PTV margin.
Sometimes bleeding happens in patients with local...
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Radiation Oncologist at Cancer Care North West
In individuals with advanced disease or who have f...
In individuals with advanced disease or who have f...