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Bleeding from unresectable gastric cancer is a localized condition that adversely affects quality of life. Radiotherapy can be used to treat gastric cancer bleeding when surgery, endoscopic treatment, and intravascular embolization are ineffective.This study analyzed the clinical results of palliative radiotherapy for bleeding control in patients with unresectable advanced gastric cancer.

We retrospectively reviewed the medical records of patients who met the following inclusion criteria between January 2012 and December 2021: histologically proven gastric cancer, gastric tumor bleeding confirmed by upper gastrointestinal endoscopy, and palliative radiotherapy performed for hemostasis. The median radiotherapy dose was 32 Gy, with a daily dose ranging from 1.8 to 8 Gy. In this study, successful hemostasis was defined as > 1 month after starting radiotherapy with the patient alive and showing no need for blood transfusion, no drop in hemoglobin, and no evidence of melena or hematemesis.

Twenty-three patients were included in this analysis. The study population was predominantly male (73.91%), with a median age of 59 years (Range: 39-73). The median baseline hemoglobin level was 6.3 g/dL, and the most common presenting symptom of gastric tumor bleeding was melena (60.86%). Bleeding control was achieved in 86.95% of patients. The median level of hemoglobin at 2 months after completion of radiotherapy were 10.2 g/dL. No toxicities of grade 2 or more were encountered. The median overall survival was 16 months. Among the 20 patients who achieved bleeding control after radiotherapy, 2 patients (8.69 %) experienced rebleeding during the follow-up period. The median time to rebleeding was 3.3 months. Chemotherapy was delivered after radiotherapy in 65.21%.

This retrospective study found that tumor bleeding was adequately controlled by radiotherapy in patients with unresectable advanced gastric cancer.