Response evaluation after single-fraction hemostatic radiotherapy in advanced cancer: a prospective study

Radiotherapy (RT) to the bleeding tumor is a potential alternative for achieving hemostasis in advanced or metastatic cancer, which is an oncologic emergency. The current study aimed to assess the effectiveness of single-fraction hemostatic RT for advanced cancer bleeding.

This prospective observational study included patients with complaints of bleeding from their primary or secondary cancer sites. All patients received 6 Gray single-fraction hemostatic radiotherapy using conventional technique. The primary endpoint was to evaluate Subjective and Objective responses following radiotherapy, with regard to achieving hemostasis.

Twenty-four patients with a median age of 45 years were included. The most common sites of bleeding were Gastrointestinal cancers (42%). The site of bleeding was the primary in 20 patients (83%), the rest had bleeding from metastatic fungating lymphadenopathy. The subjective and objective response rates to hemostatic RT were 87.5% each. The onset of response was within 24 hrs in 54.2% and at 2 weeks post-RT, there was complete control of bleeding in 45.8% of patients. The mean haemoglobin level of the study group improved by 0.9 gm/dL one week after hemostatic RT with reduced requirement of blood transfusions.

Hemostatic RT controlled bleeding in most patients irrespective of tumour site, histology and origin of bleeding. It can improve the general condition and hemoglobin levels in cancer patients, thereby making them fit for further treatments, which will likely result in prolongation of overall survival.