{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T17:49:12Z","timestamp":1792259352048,"version":"4.4.0"},"reference-count":27,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T00:00:00Z","timestamp":1655078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomedicines"],"abstract":"<jats:p>Optimal regimens using recent radiotherapy (RT) equipment for bleeding gastric cancer (GC) have not been fully investigated yet. We retrospectively reviewed the clinical data of 20 patients who received RT for bleeding GC in our institution between 2016 and 2021. Three-dimensional conformal RT was performed. The effectiveness of RT was evaluated by the mean serum hemoglobin (Hb) level and the number of transfused red blood cell (RBC) units 1 month before and after RT. The median first radiation dose was a BED of 39.9 Gy. The treatment success rate was 95% and the rebleeding rate was 10.5%. There was a significant increase in the mean Hb level (8.0 \u00b1 1.1 vs. 9.8 \u00b1 1.3 g\/dL, p = 0.01), and a significant decrease in the mean number of transfused RBC units (6.8 \u00b1 3.3 vs. 0.6 \u00b1 1.5 units, p &lt; 0.01). Severe toxicity was observed in two patients (anorexia [n = 1] and gastrointestinal [GI] perforation [n = 1]). Reirradiation was attempted in three patients (for hemostasis [n = 2] and for mass reduction [n = 1]). The retreatment success rate for rebleeding was 100%. GI perforation occurred in two patients who had received hemostatic reirradiation. Palliative RT for bleeding GC using recent technology had excellent efficacy. However, it may be associated with a risk of GI perforation.<\/jats:p>","DOI":"10.3390\/biomedicines10061394","type":"journal-article","created":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T22:00:38Z","timestamp":1655157638000},"page":"1394","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Palliative Radiotherapy for Bleeding from Unresectable Gastric Cancer Using Three-Dimensional Conformal Technique"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7162-705X","authenticated-orcid":false,"given":"Hideaki","family":"Kawabata","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Kyoto 6130034, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kyoto Okamoto Memorial Hospital, Kyoto 6130034, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Kyoto 6130034, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Satake","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Kyoto 6130034, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsutoshi","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Kyoto 6130034, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Kyoto 6130034, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kojiro","family":"Nakase","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Kyoto 6130034, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Miyata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Kyoto 6130034, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigehiro","family":"Motoi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Kyoto Okamoto Memorial Hospital, Kyoto 6130034, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J. Clin."},{"key":"ref_3","first-page":"26","article-title":"Epidemiology of gastric cancer: Global trends, risk factors and prevention","volume":"14","author":"Rawla","year":"2019","journal-title":"Prz. Gastroenterol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"13316","DOI":"10.3748\/wjg.v21.i47.13316","article-title":"Long-term outcomes after radical gastrectomy in gastric cancer patients with overt bleeding","volume":"21","author":"Wang","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/MCG.0000000000000717","article-title":"Can endoscopic bleeding control improve the prognosis of advanced gastric cancer patients? A retrospective case-control study","volume":"51","author":"Park","year":"2017","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"E700","DOI":"10.1055\/a-0593-5884","article-title":"Hemostatic powder application for control of acute upper gastrointestinal bleeding in patients with gastric malignancy","volume":"6","author":"Kim","year":"2018","journal-title":"Endosc. Int. Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1016\/j.jvir.2017.03.017","article-title":"Transcatheter arterial embolization for gastrointestinal bleeding associated with gastric carcinoma: Prognostic factors predicting successful hemostasis and survival","volume":"28","author":"Park","year":"2017","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1089\/jpm.2016.0141","article-title":"Experience of low-dose, short-course palliative radiotherapy for bleeding from unresectable gastric cancer","volume":"20","author":"Kawabata","year":"2017","journal-title":"J. Palliat. Med."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Lee, Y.H., Lee, J.W., and Jang, H.S. (2017). Palliative external beam radiotherapy for the treatment of tumor bleeding in inoperable advanced gastric cancer. BMC Cancer, 17.","DOI":"10.1186\/s12885-017-3508-x"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1007\/s10147-018-1317-0","article-title":"Efficacy of palliative radiotherapy and chemo-radiotherapy for unresectable gastric cancer demonstrating bleeding and obstruction","volume":"23","author":"Hiramoto","year":"2018","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1002\/cam4.2021","article-title":"Palliative radiotherapy in symptomatic locally advanced gastric cancer: A phase II trial","volume":"8","author":"Tey","year":"2019","journal-title":"Cancer Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"20190958","DOI":"10.1259\/bjr.20190958","article-title":"Hemostatic radiotherapy for inoperable gastric cancer: A pilot study","volume":"93","author":"Tanaka","year":"2020","journal-title":"Br. J. Radiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1186\/s13014-021-01884-5","article-title":"Efficacy of radiotherapy for gastric bleeding associated with advanced gastric cancer","volume":"16","author":"Lee","year":"2021","journal-title":"Radiat. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s10120-021-01254-w","article-title":"Treatment response after palliative radiotherapy for bleeding gastric cancer: A multicenter prospective observational study (JROSG 17-3)","volume":"25","author":"Saito","year":"2021","journal-title":"Gastric Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1007\/s12029-021-00632-y","article-title":"Verification of the utility of palliative radiotherapy for hemostasis of gastric cancer bleeding: A Case Control Study","volume":"53","author":"Sugita","year":"2021","journal-title":"J. Gastrointest. Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Yu, J., Jung, J., Park, S.R., Ryu, M.H., Park, J.H., Kim, J.H., and Yoon, S.M. (2021). Role of palliative radiotherapy in bleeding control in patients with unresectable advanced gastric cancer. BMC Cancer, 21.","DOI":"10.1186\/s12885-021-08145-4"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Kawabata, H., Hitomi, M., and Motoi, S. (2019). Management of bleeding from unresectable gastric cancer. Biomedicines, 7.","DOI":"10.3390\/biomedicines7030054"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1177\/030089160909500615","article-title":"Radiation therapy for gastric cancer bleeding","volume":"95","author":"Lee","year":"2009","journal-title":"Tumori J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1080\/02841860510007440","article-title":"The pathology of ionizing radiation as defined by morphologic patterns","volume":"44","author":"Fajardo","year":"2005","journal-title":"Acta Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1056\/NEJMra1608986","article-title":"Recent Developments in Radiotherapy","volume":"377","author":"Citrin","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1002\/acm2.12620","article-title":"Three discipline collaborative radiation therapy (3DCRT) special debate: Equipment development is stifling innovation in radiation oncology","volume":"20","author":"Kim","year":"2019","journal-title":"J. Appl. Clin. Med. Phys."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"5","DOI":"10.2739\/kurumemedj.MS6400004","article-title":"Palliative Reirradiation for Painful Bone Metastases: Clinical Cases and Literature Review","volume":"64","author":"Suzuki","year":"2018","journal-title":"Kurume Med. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.prro.2018.01.008","article-title":"Review of thoracic reirradiation with stereotactic body radiation therapy: A focus on toxicity risks","volume":"8","author":"Milano","year":"2018","journal-title":"Pract. Radiat. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.wneu.2019.01.182","article-title":"Reirradiation of recurrent brain metastases: Where do we stand?","volume":"125","author":"Chidambaram","year":"2019","journal-title":"World Neurosurg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e1644","DOI":"10.6061\/clinics\/2020\/e1644","article-title":"Palliative radiotherapy for gastric cancer: Is there a dose relationship between bleeding response and radiotherapy?","volume":"75","author":"Viani","year":"2020","journal-title":"Clinics"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3115","DOI":"10.21037\/jgo-21-361","article-title":"Pathobiology, irradiation dosimetric parameters and therapy of radiation-induced gastric damage: A narrative review","volume":"12","author":"McKay","year":"2021","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/0360-3016(91)90171-Y","article-title":"Tolerance of normal tissue to therapeutic irradiation","volume":"21","author":"Emami","year":"1991","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."}],"container-title":["Biomedicines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9059\/10\/6\/1394\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:28:45Z","timestamp":1760138925000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9059\/10\/6\/1394"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,13]]},"references-count":27,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["biomedicines10061394"],"URL":"https:\/\/doi.org\/10.3390\/biomedicines10061394","relation":{},"ISSN":["2227-9059"],"issn-type":[{"value":"2227-9059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,13]]}}}