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Haemostatic RT

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Haemostatic rt

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Haemostatic RT

  1. 1. Hemostatic Radiotherapy DR KIRAN KUMAR BR
  2. 2. Hemostasis Hemostasis is a process or steps undertaken to stop the bleeding
  3. 3. Why does tumor bleeds? • Bleeding may result from • Local vessel damage • Invasion or from systemic processes such as disseminated intravascular coagulopathy (DIC) • Abnormalities in platelet functioning and number.
  4. 4. Hemostatic Radiotherapy • Single fractions (6 – 8 Gy) of external beam radiotherapy can achieve control of hemorrhage in 80% of patients • Delivering radiation shrinks the tumor thus the aggressiveness of the tumor is relaxed which stops the bleeding
  5. 5. • In a bleeding tumor, radiotherapy is mostly started with higher doses per fraction (3–5 Gy) if required and then continued with conventionally fractionated radiotherapy, possibly in combination with palliative chemotherapy. • Usually, tumor bleeding stops within 24 to 48 hours after the beginning of irradiation or after a biologically effective dose of 20 Gy.
  6. 6. Investigations • Smaali et al – hemostatic radiotherapy for bladder cancer • 30 Gy in 10 fractions or 20 Gy in 5 fractions • Control of hemorrhage 69% • Alijabab et al – Hemostatic Radiation Therapy in Advanced Bladder Cancer • 4-10 Gy in a single fraction • Control of hemorrhage for 78%
  7. 7. • Nomoto et al – effectiveness of hemostatic radiotherapy in treatment of advanced cancer • 30 Gy in 10 fractions • Control of hemorrhage for 83% • Nikola et al – effectiveness of hemostatic radiotherapy in incurable cancer • Control of hemorrhage in 89%
  8. 8. • Biswal et.al – hemostatic radiotherapy in cervical cancer • Control of hemorrhage was 100% • Almost 85% of the patients failed locally in the form of residual, recurrent pelvic or metastatic disease, within 24 months of follow-up.
  9. 9. THANK YOU

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