Palliative Radiotherapy for Haemostasis in Malignancy: a Systematic Review

Palliative radiotherapy is commonly used to achieve haemostasis for malignancy-induced haemorrhages. Our study aimed to examine the efficacy of palliative radiotherapy in the control of haemorrhages caused by various types of malignancy. A systematic review of the literature was conducted to determi...

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Bibliographic Details
Published in:Clinical oncology (Royal College of Radiologists (Great Britain)) 2023-09, Vol.35 (9), p.e478-e488
Main Authors: Song, J., Brown, C., Dennis, K., Gaudet, M., Haddad, A.
Format: Article
Language:English
Subjects:
haemorrhage
haemostasis
malignancy
palliative
radiotherapy
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Summary:Palliative radiotherapy is commonly used to achieve haemostasis for malignancy-induced haemorrhages. Our study aimed to examine the efficacy of palliative radiotherapy in the control of haemorrhages caused by various types of malignancy. A systematic review of the literature was conducted to determine the level of evidence for the use of palliative radiotherapy in achieving haemostasis. Searches of the Medline, Embase and Cochrane databases were completed for studies published between January 1947 and May 2017. Studies that reported either a qualitative or a quantitative effect of radiotherapy were selected for inclusion during the review process. In total, 836 abstracts were screened; 13 prospective and 45 retrospective studies met the criteria for inclusion in the review. Selected studies were sorted based on the underlying tumour type to provide readers the opportunity to compare dose and fractionation schedules. Significant variations in reporting of outcomes and low total patient numbers did not allow for a quantitative analysis to be carried out. A higher median dose and a hypofractionated schedule seem to provide numerically higher rates of control based on the available data. Palliative radiotherapy is useful in the management of bleeding related to advanced and incurable malignancies. Brachytherapy seems to be effective in haemostasis of certain malignancies, especially that of gynaecological origin. Treatment should be tailored to individual patient situations given the palliative goals of any such therapy. Further prospective studies could help to delineate optimal dose and fractionation schedules. •Radiation therapy is commonly used to achieve haemostasis in malignancy-induced haemorrhages.•Significant variations exist in radiation treatments with variable clinical outcomes.•Higher doses with a low number of fractions seem to achieve higher rates of haemostasis.
ISSN:0936-6555
1433-2981
DOI:10.1016/j.clon.2023.06.007