Hemostatic single-fraction 8 Gy radiotherapy for tumor bleeding: a single-centre retrospective study

The efficacy of single-fraction 8 Gy radiotherapy (RT) for achieving hemostasis remains unclear. In this study, we assessed (1) hemostatic efficacy, (2) rebleeding, and (3) factors related to hemostatic efficacy and rebleeding associated with single-fraction 8 Gy RT.

Patients with tumor bleeding who received single-fraction 8 Gy RT between January 2020 and December 2024 were retrospectively examined. Factors associated with hemostasis and rebleeding (recurrence of bleeding signs/symptoms, need for red blood cell [RBC] transfusion or salvage treatment after confirmation of hemostasis or decreasing hemoglobin levels) were assessed.

A total of 90 lesions in 82 patients were examined. The median follow-up time after the administration of RT treatment was 80 days (interquartile range [IQR], 35-206 days; range, 7-776 days). The overall hemostatic ratio of lesions within 30 days (= 30-day hemostatic response rate) was 68.9%. In an exploratory analysis, gastroduodenal (gastrointestinal [GI]-gastroduodenal) bleeding showed a higher 30-day hemostatic response than GI-non-gastroduodenal and non-GI sites (80.4% vs. 56.8%; odds ratio, 3.08; 95% confidence interval [CI], 1.12-9.09; p = 0.02). Additionally, among evaluable patients with or without rebleeding (n = 52), the median time to rebleeding after hemostasis was 102 days (95% CI, 69-196 days). The cumulative rebleeding rates at 30 and 60 days after hemostasis were 11.8% and 24.1%, respectively.

Although this study includes patients with different cancer types, bleeding sites, and treatment backgrounds, single-fraction 8 Gy RT demonstrated potential hemostatic benefit for tumor bleeding in the palliative setting. Our findings should be interpreted cautiously because of the retrospective nature of this study.