Hemostasis irradiation for gastric cancer: comparison of whole and partial stomach irradiation in the liver and kidney

Abstract

Author(s): Osamu Tanaka*, Kousei Ono, Takuya Taniguchi, Naoyuki Sakamoto, Takuji Kiryu, Chiyoko Makita and Masayuki Matsuo

Treatment methods for advanced gastric cancer includes haemostatic radiotherapy. The usefulness of additional irradiation when re-bleeding after haemostatic irradiation has been reported. In this study, we examined the irradiation doses to the liver and kidney using partial gastric irradiation of the upper stomach and lower stomach using whole stomach irradiation as a control. Among 20 cases, the whole stomach is set as the target control. Partial stomachs were divided into 2 groups: upper stomach and lower stomach. The dose to each three PTV was set to 20 Gy/5 fractions. Whole liver and bilateral kidneys are organ at risk. The liver D5 [Dx; Dose (Gy) irradiated to x % of liver and bilateral kidney’s volume], D10, D15, D20, D30 and the kidneys D10, D15, D20, D25 were evaluated. The upper stomach was higher than the lower stomach in the high dose range of livers D20, D25, and D30. On the other hand, there was no difference between the upper and lower stomachs of livers D5, D10, and D15 in the low dose range. Renal dose was mostly significantly lower in all dose–volume histograms in the upper stomach than in the lower stomach. However, in kidney D25, the lower stomach was not significantly different from the whole stomach. In conclusion, radiation to the liver and kidneys can be reduced by partial gastric irradiation. Partial gastric irradiation is recommended if the location of the tumour can be identified using computed tomography.

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