[A Case of Unresectable Advanced Gastric Cancer Treated with Radiotherapy and Trans-Arterial Embolization, Resulting in Effective Hemostasis]

Gan To Kagaku Ryoho. 2015 Nov;42(12):1665-7.
[Article in Japanese]

Abstract

We report the case of a 70-year-old man with unresectable advanced gastric cancer because of invasion to the pancreas and multiple liver metastases. He could have continued with fourth-line chemotherapy by controlling intermittent bleeding from the cancer by means of 2 rounds of radiotherapy and trans-arterial embolization. The serum hemoglobin level declined to 4.5 g/dL during second-line chemotherapy. As the venous bleeding from the cancer was difficult to control by endoscopic hemostasis, radiotherapy with 40 Gy/20 fractions was applied to the cancer. We were able to restart chemotherapy after the hemostasis, but 6 months later, the serum hemoglobin level declined to 6.1 g/dL. Additional radiotherapy of 20 Gy/10 fractions was delivered to the tumor, and successful hemostasis was achieved; the serum hemoglobin level reached 7.5 g/dL. However, a contrast-enhanced CT, which was performed 3 weeks later, demonstrated extravasation from the cancer into the gastric cavity. We conducted trans-arterial embolization, and the patient no longer required transfusion. We planned to restart chemotherapy soon, but after 1 month, he died of pneumonia.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Arteries
  • Embolization, Therapeutic*
  • Fatal Outcome
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / therapy*
  • Hemostasis*
  • Humans
  • Liver Neoplasms / secondary
  • Liver Neoplasms / therapy
  • Male
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / therapy*