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Title: Palliative radiotherapy for gastric cancer: a systematic review and meta-analysis
Authors: Tey, Jeremy 
Soon, Yu Yang 
Koh, Wee Yao 
Leong, Cheng Nang 
Choo, Bok Ai 
Ho, Francis
Vellayappan, Balamurugan 
Lim, Keith 
Tham, Ivan Wk 
Keywords: Science & Technology
Life Sciences & Biomedicine
Cell Biology
gastric cancer
Issue Date: 11-Apr-2017
Citation: Tey, Jeremy, Soon, Yu Yang, Koh, Wee Yao, Leong, Cheng Nang, Choo, Bok Ai, Ho, Francis, Vellayappan, Balamurugan, Lim, Keith, Tham, Ivan Wk (2017-04-11). Palliative radiotherapy for gastric cancer: a systematic review and meta-analysis. ONCOTARGET 8 (15) : 25797-25805. ScholarBank@NUS Repository.
Abstract: Background/Purpose: To review the efficacy and toxicity of palliative radiotherapy (RT) for symptomatic locally advanced gastric cancer (GC) and to determine the optimal RT schedule for symptom palliation. Methods: We searched MEDLINE and CENTRAL for eligible studies published from 1995 to 2015. Outcomes of interest were relief of bleeding, pain and obstruction. Results: Seven non-comparative observational studies were included. There were large variations in RT dose and fractionation. The pooled overall response rates for bleeding, pain and obstruction symptoms were 74%, 67% and 68% respectively. There was no difference in response rate of bleeding between regimens with high biological equivalent dose (BED) of = 39Gy versus regimens with low BED < 39Gy regimens (p value =0.39). Grade 3 to 4 toxicities occurred in up to 15% of patients for patients treated with RT alone and up to 25% of patients treated with chemoradiotherapy. Health-related quality of life (HRQL) outcomes were not reported. Conclusion: More than two-thirds of patients receiving RT would have a clinical benefit. Low BED regimens appear to be adequate for symptom palliation. Toxicity rates appear acceptable for patients treated with RT alone. The optimal dose fractionation regimen for symptom palliation remains unclear. Prospective studies to determine the effects of palliative gastric RT on HRQL outcomes are warranted.
Source Title: ONCOTARGET
ISSN: 19492553
DOI: 10.18632/oncotarget.15554
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