Hemostatic radiotherapy

Abstract

Radiotherapy is one of the widely used modalities of treatment in an oncology setting whether the approach to treat cancer is either curative or palliative. Tumor masses bleeding is not an uncommon emergency in cancer patients and local radiotherapy is very commonly used as a hemostatic therapy. Hemostatic radiotherapy is used in wide variety of cancers such as head-and-neck cancers including oral tongue and base of tongue cancers more commonly, fungating and bleeding neck nodes, bleeding bronchial, and lung tumors presenting as hemoptysis, pelvic malignancies most commonly includes cervical cancers presenting as bleeding per vaginum. teletherapy as well as brachytherapy both can be used for alleviation of symptoms thus avoiding a protracted course and improving the quality of life of patients. The radiotherapy doses of 40 Gray in 15 fractions, 30 Gray in 10 fractions, 20 Gray in 5 fractions, 15 Gray in 5 fractions,8 Gray in single fraction and 4 Gray in single fraction have been used which are equally effective for controlling bleeding but protracted courses should be avoided to prevent treatment dropouts. Long-term side effects are more to be worried of in cases of hypofractionation but such patients have a poor median survival generally so symptom alleviation should be our utmost target. Hypofractionated palliative hemostatic radiotherapy is very effective for the alleviation of symptoms and the purpose of the treatment approach but individualized patient-based decisions should be used for tumor control if to be planned further.

Keywords

• brachytherapy
• hemostatic radiation
• hypofractionation
• palliation