胃癌出血に対する放射線治療の検討

Palliative radiotherapy for bleeding gastric cancer

胃癌出血に対する局所療法は，手術・内視鏡的止血術・血管内治療・放射線治療が用いられる。手術が最も確実な止血効果を有するが，侵襲性が強く，その適用となる症例は限られている。一方，手術以外の局所療法による止血効果に関する報告は，いずれもばらつきが大きく，奏効率としては約30～100％であり^1），局所療法の選択は患者希望・主治医判断に委ねられる部分が大きい。

Currently, palliative radiotherapy for bleeding gastric cancer is not sufficiently widespread. In our institution, between September 2016 and December 2020, 11 patients treated with palliative radiotherapy of 30-40 Gy in 10-16 fractions for bleeding gastric cancer and were retrospectively reviewed. The median survival time was 7 months（range, 1-21 months）, and the median hemostasis time was 6 months（range, 1-17 months）. The hemostasis rate was 100％ after starting irradiation, and re-bleeding was observed in 36％（4/11 patients）. The median hemostasis time did not differ significantly from the median survival time, and palliative radiotherapy is considered to be one of the useful options for hemostasis.