1.
Hemostatic Radiotherapy
DR KIRAN KUMAR BR

2.
Hemostasis
Hemostasis is a process or steps undertaken to stop the bleeding

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.
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.
• 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.
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.
• 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.
• 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.
THANK YOU