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 ...
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...