Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study

Abstract Background Patients with unresectable pancreatic cancer (PC) sometimes experience gastrointestinal bleeding (GIB) due to tumor invasion of the gastrointestinal tract (tumor bleeding); no standard treatment has been established yet for this complication. Palliative radiotherapy (PRT) could be promising, however, there are few reports of PRT for tumor bleeding in patients with unresectable PC. Therefore, we evaluated the outcomes of PRT for tumor bleeding in patients with unresectable PC. Methods We reviewed the medical records of patients with unresectable PC diagnosed at our institution between May 2013 and January 2022, and identified patients with endoscopically confirmed tumor bleeding who had received PRT. PRT was administered at a total dose of 30 Grays (Gy) in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in a single fraction, and the dose selection was left to the discretion of the attending radiation oncologists. Results During the study period, 2562 patients were diagnosed as having unresectable PC at our hospital, of which 225 (8.8%) developed GIB. Among the 225 patients, 63 (2.5%) were diagnosed as having tumor bleeding and 20 (0.8%) received PRT. Hemostasis was achieved in 14 of the 20 patients (70%) who received PRT, and none of these patients developed grade 3 or more adverse events related to the PRT. The median time to hemostasis was 8.5 days (range 7–14 days). The rebleeding rate was 21.4% (3/14). The median hemoglobin level increased significantly (p < 0.001) from 5.9 to 9.1 g/dL, and the median volume of red blood cell transfusion tended (p = 0.052) to decrease, from 1120 mL (range 280–3360 mL) to 280 mL (range 0–5560 mL) following the PRT. The median overall survival (OS) was 52 days (95% confidence interval [CI] 39–317). Of the 14 patients in whom hemostasis was achieved following PRT, chemotherapy could be started/resumed in seven patients (50%), and the median OS in these patients was 260 days (95% CI 76–not evaluable [NE]). Three patients experienced rebleeding (21.4%), on days 16, 22, and 25, after the start of PRT. Conclusion This study showed that PRT is an effective and safe treatment modality for tumor bleeding in patients with unresectable PC. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Taro Shibuki [verfasserIn] Mitsuhito Sasaki [verfasserIn] Shota Yamaguchi [verfasserIn] Kanae Inoue [verfasserIn] Tomonao Taira [verfasserIn] Tomoyuki Satake [verfasserIn] Kazuo Watanabe [verfasserIn] Hiroshi Imaoka [verfasserIn] Shuichi Mitsunaga [verfasserIn] Takeshi Fujisawa [verfasserIn] Kento Tomizawa [verfasserIn] Hidekazu Oyoshi [verfasserIn] Masaki Nakamura [verfasserIn] Hidehiro Hojo [verfasserIn] Masafumi Ikeda [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Palliative radiotherapy Bleeding Pancreatic cancer Hemostasis

Übergeordnetes Werk:	In: Radiation Oncology - BMC, 2006, 18(2023), 1, Seite 9
Übergeordnetes Werk:	volume:18 ; year:2023 ; number:1 ; pages:9

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/s13014-023-02367-5

Katalog-ID:	DOAJ095328041

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520			\|a Abstract Background Patients with unresectable pancreatic cancer (PC) sometimes experience gastrointestinal bleeding (GIB) due to tumor invasion of the gastrointestinal tract (tumor bleeding); no standard treatment has been established yet for this complication. Palliative radiotherapy (PRT) could be promising, however, there are few reports of PRT for tumor bleeding in patients with unresectable PC. Therefore, we evaluated the outcomes of PRT for tumor bleeding in patients with unresectable PC. Methods We reviewed the medical records of patients with unresectable PC diagnosed at our institution between May 2013 and January 2022, and identified patients with endoscopically confirmed tumor bleeding who had received PRT. PRT was administered at a total dose of 30 Grays (Gy) in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in a single fraction, and the dose selection was left to the discretion of the attending radiation oncologists. Results During the study period, 2562 patients were diagnosed as having unresectable PC at our hospital, of which 225 (8.8%) developed GIB. Among the 225 patients, 63 (2.5%) were diagnosed as having tumor bleeding and 20 (0.8%) received PRT. Hemostasis was achieved in 14 of the 20 patients (70%) who received PRT, and none of these patients developed grade 3 or more adverse events related to the PRT. The median time to hemostasis was 8.5 days (range 7–14 days). The rebleeding rate was 21.4% (3/14). The median hemoglobin level increased significantly (p < 0.001) from 5.9 to 9.1 g/dL, and the median volume of red blood cell transfusion tended (p = 0.052) to decrease, from 1120 mL (range 280–3360 mL) to 280 mL (range 0–5560 mL) following the PRT. The median overall survival (OS) was 52 days (95% confidence interval [CI] 39–317). Of the 14 patients in whom hemostasis was achieved following PRT, chemotherapy could be started/resumed in seven patients (50%), and the median OS in these patients was 260 days (95% CI 76–not evaluable [NE]). Three patients experienced rebleeding (21.4%), on days 16, 22, and 25, after the start of PRT. Conclusion This study showed that PRT is an effective and safe treatment modality for tumor bleeding in patients with unresectable PC.
650		4	\|a Palliative radiotherapy
650		4	\|a Bleeding
650		4	\|a Pancreatic cancer
650		4	\|a Hemostasis
653		0	\|a Medical physics. Medical radiology. Nuclear medicine
653		0	\|a Neoplasms. Tumors. Oncology. Including cancer and carcinogens
700	0		\|a Mitsuhito Sasaki \|e verfasserin \|4 aut
700	0		\|a Shota Yamaguchi \|e verfasserin \|4 aut
700	0		\|a Kanae Inoue \|e verfasserin \|4 aut
700	0		\|a Tomonao Taira \|e verfasserin \|4 aut
700	0		\|a Tomoyuki Satake \|e verfasserin \|4 aut
700	0		\|a Kazuo Watanabe \|e verfasserin \|4 aut
700	0		\|a Hiroshi Imaoka \|e verfasserin \|4 aut
700	0		\|a Shuichi Mitsunaga \|e verfasserin \|4 aut
700	0		\|a Takeshi Fujisawa \|e verfasserin \|4 aut
700	0		\|a Kento Tomizawa \|e verfasserin \|4 aut
700	0		\|a Hidekazu Oyoshi \|e verfasserin \|4 aut
700	0		\|a Masaki Nakamura \|e verfasserin \|4 aut
700	0		\|a Hidehiro Hojo \|e verfasserin \|4 aut
700	0		\|a Masafumi Ikeda \|e verfasserin \|4 aut
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allfields	10.1186/s13014-023-02367-5 doi (DE-627)DOAJ095328041 (DE-599)DOAJf5e2e82d53b14455a922f792aac2eb6e DE-627 ger DE-627 rakwb eng R895-920 RC254-282 Taro Shibuki verfasserin aut Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Patients with unresectable pancreatic cancer (PC) sometimes experience gastrointestinal bleeding (GIB) due to tumor invasion of the gastrointestinal tract (tumor bleeding); no standard treatment has been established yet for this complication. Palliative radiotherapy (PRT) could be promising, however, there are few reports of PRT for tumor bleeding in patients with unresectable PC. Therefore, we evaluated the outcomes of PRT for tumor bleeding in patients with unresectable PC. Methods We reviewed the medical records of patients with unresectable PC diagnosed at our institution between May 2013 and January 2022, and identified patients with endoscopically confirmed tumor bleeding who had received PRT. PRT was administered at a total dose of 30 Grays (Gy) in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in a single fraction, and the dose selection was left to the discretion of the attending radiation oncologists. Results During the study period, 2562 patients were diagnosed as having unresectable PC at our hospital, of which 225 (8.8%) developed GIB. Among the 225 patients, 63 (2.5%) were diagnosed as having tumor bleeding and 20 (0.8%) received PRT. Hemostasis was achieved in 14 of the 20 patients (70%) who received PRT, and none of these patients developed grade 3 or more adverse events related to the PRT. The median time to hemostasis was 8.5 days (range 7–14 days). The rebleeding rate was 21.4% (3/14). The median hemoglobin level increased significantly (p < 0.001) from 5.9 to 9.1 g/dL, and the median volume of red blood cell transfusion tended (p = 0.052) to decrease, from 1120 mL (range 280–3360 mL) to 280 mL (range 0–5560 mL) following the PRT. The median overall survival (OS) was 52 days (95% confidence interval [CI] 39–317). Of the 14 patients in whom hemostasis was achieved following PRT, chemotherapy could be started/resumed in seven patients (50%), and the median OS in these patients was 260 days (95% CI 76–not evaluable [NE]). Three patients experienced rebleeding (21.4%), on days 16, 22, and 25, after the start of PRT. Conclusion This study showed that PRT is an effective and safe treatment modality for tumor bleeding in patients with unresectable PC. Palliative radiotherapy Bleeding Pancreatic cancer Hemostasis Medical physics. Medical radiology. Nuclear medicine Neoplasms. Tumors. Oncology. Including cancer and carcinogens Mitsuhito Sasaki verfasserin aut Shota Yamaguchi verfasserin aut Kanae Inoue verfasserin aut Tomonao Taira verfasserin aut Tomoyuki Satake verfasserin aut Kazuo Watanabe verfasserin aut Hiroshi Imaoka verfasserin aut Shuichi Mitsunaga verfasserin aut Takeshi Fujisawa verfasserin aut Kento Tomizawa verfasserin aut Hidekazu Oyoshi verfasserin aut Masaki Nakamura verfasserin aut Hidehiro Hojo verfasserin aut Masafumi Ikeda verfasserin aut In Radiation Oncology BMC, 2006 18(2023), 1, Seite 9 (DE-627)508725739 (DE-600)2224965-5 1748717X nnns volume:18 year:2023 number:1 pages:9 https://doi.org/10.1186/s13014-023-02367-5 kostenfrei https://doaj.org/article/f5e2e82d53b14455a922f792aac2eb6e kostenfrei https://doi.org/10.1186/s13014-023-02367-5 kostenfrei https://doaj.org/toc/1748-717X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 1 9
spelling	10.1186/s13014-023-02367-5 doi (DE-627)DOAJ095328041 (DE-599)DOAJf5e2e82d53b14455a922f792aac2eb6e DE-627 ger DE-627 rakwb eng R895-920 RC254-282 Taro Shibuki verfasserin aut Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Patients with unresectable pancreatic cancer (PC) sometimes experience gastrointestinal bleeding (GIB) due to tumor invasion of the gastrointestinal tract (tumor bleeding); no standard treatment has been established yet for this complication. Palliative radiotherapy (PRT) could be promising, however, there are few reports of PRT for tumor bleeding in patients with unresectable PC. Therefore, we evaluated the outcomes of PRT for tumor bleeding in patients with unresectable PC. Methods We reviewed the medical records of patients with unresectable PC diagnosed at our institution between May 2013 and January 2022, and identified patients with endoscopically confirmed tumor bleeding who had received PRT. PRT was administered at a total dose of 30 Grays (Gy) in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in a single fraction, and the dose selection was left to the discretion of the attending radiation oncologists. Results During the study period, 2562 patients were diagnosed as having unresectable PC at our hospital, of which 225 (8.8%) developed GIB. Among the 225 patients, 63 (2.5%) were diagnosed as having tumor bleeding and 20 (0.8%) received PRT. Hemostasis was achieved in 14 of the 20 patients (70%) who received PRT, and none of these patients developed grade 3 or more adverse events related to the PRT. The median time to hemostasis was 8.5 days (range 7–14 days). The rebleeding rate was 21.4% (3/14). The median hemoglobin level increased significantly (p < 0.001) from 5.9 to 9.1 g/dL, and the median volume of red blood cell transfusion tended (p = 0.052) to decrease, from 1120 mL (range 280–3360 mL) to 280 mL (range 0–5560 mL) following the PRT. The median overall survival (OS) was 52 days (95% confidence interval [CI] 39–317). Of the 14 patients in whom hemostasis was achieved following PRT, chemotherapy could be started/resumed in seven patients (50%), and the median OS in these patients was 260 days (95% CI 76–not evaluable [NE]). Three patients experienced rebleeding (21.4%), on days 16, 22, and 25, after the start of PRT. Conclusion This study showed that PRT is an effective and safe treatment modality for tumor bleeding in patients with unresectable PC. Palliative radiotherapy Bleeding Pancreatic cancer Hemostasis Medical physics. Medical radiology. Nuclear medicine Neoplasms. Tumors. Oncology. Including cancer and carcinogens Mitsuhito Sasaki verfasserin aut Shota Yamaguchi verfasserin aut Kanae Inoue verfasserin aut Tomonao Taira verfasserin aut Tomoyuki Satake verfasserin aut Kazuo Watanabe verfasserin aut Hiroshi Imaoka verfasserin aut Shuichi Mitsunaga verfasserin aut Takeshi Fujisawa verfasserin aut Kento Tomizawa verfasserin aut Hidekazu Oyoshi verfasserin aut Masaki Nakamura verfasserin aut Hidehiro Hojo verfasserin aut Masafumi Ikeda verfasserin aut In Radiation Oncology BMC, 2006 18(2023), 1, Seite 9 (DE-627)508725739 (DE-600)2224965-5 1748717X nnns volume:18 year:2023 number:1 pages:9 https://doi.org/10.1186/s13014-023-02367-5 kostenfrei https://doaj.org/article/f5e2e82d53b14455a922f792aac2eb6e kostenfrei https://doi.org/10.1186/s13014-023-02367-5 kostenfrei https://doaj.org/toc/1748-717X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 1 9
allfields_unstemmed	10.1186/s13014-023-02367-5 doi (DE-627)DOAJ095328041 (DE-599)DOAJf5e2e82d53b14455a922f792aac2eb6e DE-627 ger DE-627 rakwb eng R895-920 RC254-282 Taro Shibuki verfasserin aut Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Patients with unresectable pancreatic cancer (PC) sometimes experience gastrointestinal bleeding (GIB) due to tumor invasion of the gastrointestinal tract (tumor bleeding); no standard treatment has been established yet for this complication. Palliative radiotherapy (PRT) could be promising, however, there are few reports of PRT for tumor bleeding in patients with unresectable PC. Therefore, we evaluated the outcomes of PRT for tumor bleeding in patients with unresectable PC. Methods We reviewed the medical records of patients with unresectable PC diagnosed at our institution between May 2013 and January 2022, and identified patients with endoscopically confirmed tumor bleeding who had received PRT. PRT was administered at a total dose of 30 Grays (Gy) in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in a single fraction, and the dose selection was left to the discretion of the attending radiation oncologists. Results During the study period, 2562 patients were diagnosed as having unresectable PC at our hospital, of which 225 (8.8%) developed GIB. Among the 225 patients, 63 (2.5%) were diagnosed as having tumor bleeding and 20 (0.8%) received PRT. Hemostasis was achieved in 14 of the 20 patients (70%) who received PRT, and none of these patients developed grade 3 or more adverse events related to the PRT. The median time to hemostasis was 8.5 days (range 7–14 days). The rebleeding rate was 21.4% (3/14). The median hemoglobin level increased significantly (p < 0.001) from 5.9 to 9.1 g/dL, and the median volume of red blood cell transfusion tended (p = 0.052) to decrease, from 1120 mL (range 280–3360 mL) to 280 mL (range 0–5560 mL) following the PRT. The median overall survival (OS) was 52 days (95% confidence interval [CI] 39–317). Of the 14 patients in whom hemostasis was achieved following PRT, chemotherapy could be started/resumed in seven patients (50%), and the median OS in these patients was 260 days (95% CI 76–not evaluable [NE]). Three patients experienced rebleeding (21.4%), on days 16, 22, and 25, after the start of PRT. Conclusion This study showed that PRT is an effective and safe treatment modality for tumor bleeding in patients with unresectable PC. Palliative radiotherapy Bleeding Pancreatic cancer Hemostasis Medical physics. Medical radiology. Nuclear medicine Neoplasms. Tumors. Oncology. Including cancer and carcinogens Mitsuhito Sasaki verfasserin aut Shota Yamaguchi verfasserin aut Kanae Inoue verfasserin aut Tomonao Taira verfasserin aut Tomoyuki Satake verfasserin aut Kazuo Watanabe verfasserin aut Hiroshi Imaoka verfasserin aut Shuichi Mitsunaga verfasserin aut Takeshi Fujisawa verfasserin aut Kento Tomizawa verfasserin aut Hidekazu Oyoshi verfasserin aut Masaki Nakamura verfasserin aut Hidehiro Hojo verfasserin aut Masafumi Ikeda verfasserin aut In Radiation Oncology BMC, 2006 18(2023), 1, Seite 9 (DE-627)508725739 (DE-600)2224965-5 1748717X nnns volume:18 year:2023 number:1 pages:9 https://doi.org/10.1186/s13014-023-02367-5 kostenfrei https://doaj.org/article/f5e2e82d53b14455a922f792aac2eb6e kostenfrei https://doi.org/10.1186/s13014-023-02367-5 kostenfrei https://doaj.org/toc/1748-717X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 1 9
allfieldsGer	10.1186/s13014-023-02367-5 doi (DE-627)DOAJ095328041 (DE-599)DOAJf5e2e82d53b14455a922f792aac2eb6e DE-627 ger DE-627 rakwb eng R895-920 RC254-282 Taro Shibuki verfasserin aut Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Patients with unresectable pancreatic cancer (PC) sometimes experience gastrointestinal bleeding (GIB) due to tumor invasion of the gastrointestinal tract (tumor bleeding); no standard treatment has been established yet for this complication. Palliative radiotherapy (PRT) could be promising, however, there are few reports of PRT for tumor bleeding in patients with unresectable PC. Therefore, we evaluated the outcomes of PRT for tumor bleeding in patients with unresectable PC. Methods We reviewed the medical records of patients with unresectable PC diagnosed at our institution between May 2013 and January 2022, and identified patients with endoscopically confirmed tumor bleeding who had received PRT. PRT was administered at a total dose of 30 Grays (Gy) in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in a single fraction, and the dose selection was left to the discretion of the attending radiation oncologists. Results During the study period, 2562 patients were diagnosed as having unresectable PC at our hospital, of which 225 (8.8%) developed GIB. Among the 225 patients, 63 (2.5%) were diagnosed as having tumor bleeding and 20 (0.8%) received PRT. Hemostasis was achieved in 14 of the 20 patients (70%) who received PRT, and none of these patients developed grade 3 or more adverse events related to the PRT. The median time to hemostasis was 8.5 days (range 7–14 days). The rebleeding rate was 21.4% (3/14). The median hemoglobin level increased significantly (p < 0.001) from 5.9 to 9.1 g/dL, and the median volume of red blood cell transfusion tended (p = 0.052) to decrease, from 1120 mL (range 280–3360 mL) to 280 mL (range 0–5560 mL) following the PRT. The median overall survival (OS) was 52 days (95% confidence interval [CI] 39–317). Of the 14 patients in whom hemostasis was achieved following PRT, chemotherapy could be started/resumed in seven patients (50%), and the median OS in these patients was 260 days (95% CI 76–not evaluable [NE]). Three patients experienced rebleeding (21.4%), on days 16, 22, and 25, after the start of PRT. Conclusion This study showed that PRT is an effective and safe treatment modality for tumor bleeding in patients with unresectable PC. Palliative radiotherapy Bleeding Pancreatic cancer Hemostasis Medical physics. Medical radiology. Nuclear medicine Neoplasms. Tumors. Oncology. Including cancer and carcinogens Mitsuhito Sasaki verfasserin aut Shota Yamaguchi verfasserin aut Kanae Inoue verfasserin aut Tomonao Taira verfasserin aut Tomoyuki Satake verfasserin aut Kazuo Watanabe verfasserin aut Hiroshi Imaoka verfasserin aut Shuichi Mitsunaga verfasserin aut Takeshi Fujisawa verfasserin aut Kento Tomizawa verfasserin aut Hidekazu Oyoshi verfasserin aut Masaki Nakamura verfasserin aut Hidehiro Hojo verfasserin aut Masafumi Ikeda verfasserin aut In Radiation Oncology BMC, 2006 18(2023), 1, Seite 9 (DE-627)508725739 (DE-600)2224965-5 1748717X nnns volume:18 year:2023 number:1 pages:9 https://doi.org/10.1186/s13014-023-02367-5 kostenfrei https://doaj.org/article/f5e2e82d53b14455a922f792aac2eb6e kostenfrei https://doi.org/10.1186/s13014-023-02367-5 kostenfrei https://doaj.org/toc/1748-717X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 1 9
allfieldsSound	10.1186/s13014-023-02367-5 doi (DE-627)DOAJ095328041 (DE-599)DOAJf5e2e82d53b14455a922f792aac2eb6e DE-627 ger DE-627 rakwb eng R895-920 RC254-282 Taro Shibuki verfasserin aut Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Patients with unresectable pancreatic cancer (PC) sometimes experience gastrointestinal bleeding (GIB) due to tumor invasion of the gastrointestinal tract (tumor bleeding); no standard treatment has been established yet for this complication. Palliative radiotherapy (PRT) could be promising, however, there are few reports of PRT for tumor bleeding in patients with unresectable PC. Therefore, we evaluated the outcomes of PRT for tumor bleeding in patients with unresectable PC. Methods We reviewed the medical records of patients with unresectable PC diagnosed at our institution between May 2013 and January 2022, and identified patients with endoscopically confirmed tumor bleeding who had received PRT. PRT was administered at a total dose of 30 Grays (Gy) in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in a single fraction, and the dose selection was left to the discretion of the attending radiation oncologists. Results During the study period, 2562 patients were diagnosed as having unresectable PC at our hospital, of which 225 (8.8%) developed GIB. Among the 225 patients, 63 (2.5%) were diagnosed as having tumor bleeding and 20 (0.8%) received PRT. Hemostasis was achieved in 14 of the 20 patients (70%) who received PRT, and none of these patients developed grade 3 or more adverse events related to the PRT. The median time to hemostasis was 8.5 days (range 7–14 days). The rebleeding rate was 21.4% (3/14). The median hemoglobin level increased significantly (p < 0.001) from 5.9 to 9.1 g/dL, and the median volume of red blood cell transfusion tended (p = 0.052) to decrease, from 1120 mL (range 280–3360 mL) to 280 mL (range 0–5560 mL) following the PRT. The median overall survival (OS) was 52 days (95% confidence interval [CI] 39–317). Of the 14 patients in whom hemostasis was achieved following PRT, chemotherapy could be started/resumed in seven patients (50%), and the median OS in these patients was 260 days (95% CI 76–not evaluable [NE]). Three patients experienced rebleeding (21.4%), on days 16, 22, and 25, after the start of PRT. Conclusion This study showed that PRT is an effective and safe treatment modality for tumor bleeding in patients with unresectable PC. Palliative radiotherapy Bleeding Pancreatic cancer Hemostasis Medical physics. Medical radiology. Nuclear medicine Neoplasms. Tumors. Oncology. Including cancer and carcinogens Mitsuhito Sasaki verfasserin aut Shota Yamaguchi verfasserin aut Kanae Inoue verfasserin aut Tomonao Taira verfasserin aut Tomoyuki Satake verfasserin aut Kazuo Watanabe verfasserin aut Hiroshi Imaoka verfasserin aut Shuichi Mitsunaga verfasserin aut Takeshi Fujisawa verfasserin aut Kento Tomizawa verfasserin aut Hidekazu Oyoshi verfasserin aut Masaki Nakamura verfasserin aut Hidehiro Hojo verfasserin aut Masafumi Ikeda verfasserin aut In Radiation Oncology BMC, 2006 18(2023), 1, Seite 9 (DE-627)508725739 (DE-600)2224965-5 1748717X nnns volume:18 year:2023 number:1 pages:9 https://doi.org/10.1186/s13014-023-02367-5 kostenfrei https://doaj.org/article/f5e2e82d53b14455a922f792aac2eb6e kostenfrei https://doi.org/10.1186/s13014-023-02367-5 kostenfrei https://doaj.org/toc/1748-717X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 1 9
language	English
source	In Radiation Oncology 18(2023), 1, Seite 9 volume:18 year:2023 number:1 pages:9
sourceStr	In Radiation Oncology 18(2023), 1, Seite 9 volume:18 year:2023 number:1 pages:9
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Palliative radiotherapy Bleeding Pancreatic cancer Hemostasis Medical physics. Medical radiology. Nuclear medicine Neoplasms. Tumors. Oncology. Including cancer and carcinogens
isfreeaccess_bool	true
container_title	Radiation Oncology
authorswithroles_txt_mv	Taro Shibuki @@aut@@ Mitsuhito Sasaki @@aut@@ Shota Yamaguchi @@aut@@ Kanae Inoue @@aut@@ Tomonao Taira @@aut@@ Tomoyuki Satake @@aut@@ Kazuo Watanabe @@aut@@ Hiroshi Imaoka @@aut@@ Shuichi Mitsunaga @@aut@@ Takeshi Fujisawa @@aut@@ Kento Tomizawa @@aut@@ Hidekazu Oyoshi @@aut@@ Masaki Nakamura @@aut@@ Hidehiro Hojo @@aut@@ Masafumi Ikeda @@aut@@
publishDateDaySort_date	2023-01-01T00:00:00Z
hierarchy_top_id	508725739
id	DOAJ095328041
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">DOAJ095328041</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20240413205409.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">240413s2023 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1186/s13014-023-02367-5</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ095328041</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJf5e2e82d53b14455a922f792aac2eb6e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">R895-920</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RC254-282</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Taro Shibuki</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Abstract Background Patients with unresectable pancreatic cancer (PC) sometimes experience gastrointestinal bleeding (GIB) due to tumor invasion of the gastrointestinal tract (tumor bleeding); no standard treatment has been established yet for this complication. Palliative radiotherapy (PRT) could be promising, however, there are few reports of PRT for tumor bleeding in patients with unresectable PC. Therefore, we evaluated the outcomes of PRT for tumor bleeding in patients with unresectable PC. Methods We reviewed the medical records of patients with unresectable PC diagnosed at our institution between May 2013 and January 2022, and identified patients with endoscopically confirmed tumor bleeding who had received PRT. PRT was administered at a total dose of 30 Grays (Gy) in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in a single fraction, and the dose selection was left to the discretion of the attending radiation oncologists. Results During the study period, 2562 patients were diagnosed as having unresectable PC at our hospital, of which 225 (8.8%) developed GIB. Among the 225 patients, 63 (2.5%) were diagnosed as having tumor bleeding and 20 (0.8%) received PRT. Hemostasis was achieved in 14 of the 20 patients (70%) who received PRT, and none of these patients developed grade 3 or more adverse events related to the PRT. The median time to hemostasis was 8.5 days (range 7–14 days). The rebleeding rate was 21.4% (3/14). The median hemoglobin level increased significantly (p < 0.001) from 5.9 to 9.1 g/dL, and the median volume of red blood cell transfusion tended (p = 0.052) to decrease, from 1120 mL (range 280–3360 mL) to 280 mL (range 0–5560 mL) following the PRT. The median overall survival (OS) was 52 days (95% confidence interval [CI] 39–317). Of the 14 patients in whom hemostasis was achieved following PRT, chemotherapy could be started/resumed in seven patients (50%), and the median OS in these patients was 260 days (95% CI 76–not evaluable [NE]). Three patients experienced rebleeding (21.4%), on days 16, 22, and 25, after the start of PRT. 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callnumber-first	R - Medicine
author	Taro Shibuki
spellingShingle	Taro Shibuki misc R895-920 misc RC254-282 misc Palliative radiotherapy misc Bleeding misc Pancreatic cancer misc Hemostasis misc Medical physics. Medical radiology. Nuclear medicine misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study
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topic_title	R895-920 RC254-282 Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study Palliative radiotherapy Bleeding Pancreatic cancer Hemostasis
topic	misc R895-920 misc RC254-282 misc Palliative radiotherapy misc Bleeding misc Pancreatic cancer misc Hemostasis misc Medical physics. Medical radiology. Nuclear medicine misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
topic_unstemmed	misc R895-920 misc RC254-282 misc Palliative radiotherapy misc Bleeding misc Pancreatic cancer misc Hemostasis misc Medical physics. Medical radiology. Nuclear medicine misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
topic_browse	misc R895-920 misc RC254-282 misc Palliative radiotherapy misc Bleeding misc Pancreatic cancer misc Hemostasis misc Medical physics. Medical radiology. Nuclear medicine misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
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title	Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study
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title_full	Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study
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author_browse	Taro Shibuki Mitsuhito Sasaki Shota Yamaguchi Kanae Inoue Tomonao Taira Tomoyuki Satake Kazuo Watanabe Hiroshi Imaoka Shuichi Mitsunaga Takeshi Fujisawa Kento Tomizawa Hidekazu Oyoshi Masaki Nakamura Hidehiro Hojo Masafumi Ikeda
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title_sort	palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study
callnumber	R895-920
title_auth	Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study
abstract	Abstract Background Patients with unresectable pancreatic cancer (PC) sometimes experience gastrointestinal bleeding (GIB) due to tumor invasion of the gastrointestinal tract (tumor bleeding); no standard treatment has been established yet for this complication. Palliative radiotherapy (PRT) could be promising, however, there are few reports of PRT for tumor bleeding in patients with unresectable PC. Therefore, we evaluated the outcomes of PRT for tumor bleeding in patients with unresectable PC. Methods We reviewed the medical records of patients with unresectable PC diagnosed at our institution between May 2013 and January 2022, and identified patients with endoscopically confirmed tumor bleeding who had received PRT. PRT was administered at a total dose of 30 Grays (Gy) in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in a single fraction, and the dose selection was left to the discretion of the attending radiation oncologists. Results During the study period, 2562 patients were diagnosed as having unresectable PC at our hospital, of which 225 (8.8%) developed GIB. Among the 225 patients, 63 (2.5%) were diagnosed as having tumor bleeding and 20 (0.8%) received PRT. Hemostasis was achieved in 14 of the 20 patients (70%) who received PRT, and none of these patients developed grade 3 or more adverse events related to the PRT. The median time to hemostasis was 8.5 days (range 7–14 days). The rebleeding rate was 21.4% (3/14). The median hemoglobin level increased significantly (p < 0.001) from 5.9 to 9.1 g/dL, and the median volume of red blood cell transfusion tended (p = 0.052) to decrease, from 1120 mL (range 280–3360 mL) to 280 mL (range 0–5560 mL) following the PRT. The median overall survival (OS) was 52 days (95% confidence interval [CI] 39–317). Of the 14 patients in whom hemostasis was achieved following PRT, chemotherapy could be started/resumed in seven patients (50%), and the median OS in these patients was 260 days (95% CI 76–not evaluable [NE]). Three patients experienced rebleeding (21.4%), on days 16, 22, and 25, after the start of PRT. Conclusion This study showed that PRT is an effective and safe treatment modality for tumor bleeding in patients with unresectable PC.
abstractGer	Abstract Background Patients with unresectable pancreatic cancer (PC) sometimes experience gastrointestinal bleeding (GIB) due to tumor invasion of the gastrointestinal tract (tumor bleeding); no standard treatment has been established yet for this complication. Palliative radiotherapy (PRT) could be promising, however, there are few reports of PRT for tumor bleeding in patients with unresectable PC. Therefore, we evaluated the outcomes of PRT for tumor bleeding in patients with unresectable PC. Methods We reviewed the medical records of patients with unresectable PC diagnosed at our institution between May 2013 and January 2022, and identified patients with endoscopically confirmed tumor bleeding who had received PRT. PRT was administered at a total dose of 30 Grays (Gy) in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in a single fraction, and the dose selection was left to the discretion of the attending radiation oncologists. Results During the study period, 2562 patients were diagnosed as having unresectable PC at our hospital, of which 225 (8.8%) developed GIB. Among the 225 patients, 63 (2.5%) were diagnosed as having tumor bleeding and 20 (0.8%) received PRT. Hemostasis was achieved in 14 of the 20 patients (70%) who received PRT, and none of these patients developed grade 3 or more adverse events related to the PRT. The median time to hemostasis was 8.5 days (range 7–14 days). The rebleeding rate was 21.4% (3/14). The median hemoglobin level increased significantly (p < 0.001) from 5.9 to 9.1 g/dL, and the median volume of red blood cell transfusion tended (p = 0.052) to decrease, from 1120 mL (range 280–3360 mL) to 280 mL (range 0–5560 mL) following the PRT. The median overall survival (OS) was 52 days (95% confidence interval [CI] 39–317). Of the 14 patients in whom hemostasis was achieved following PRT, chemotherapy could be started/resumed in seven patients (50%), and the median OS in these patients was 260 days (95% CI 76–not evaluable [NE]). Three patients experienced rebleeding (21.4%), on days 16, 22, and 25, after the start of PRT. Conclusion This study showed that PRT is an effective and safe treatment modality for tumor bleeding in patients with unresectable PC.
abstract_unstemmed	Abstract Background Patients with unresectable pancreatic cancer (PC) sometimes experience gastrointestinal bleeding (GIB) due to tumor invasion of the gastrointestinal tract (tumor bleeding); no standard treatment has been established yet for this complication. Palliative radiotherapy (PRT) could be promising, however, there are few reports of PRT for tumor bleeding in patients with unresectable PC. Therefore, we evaluated the outcomes of PRT for tumor bleeding in patients with unresectable PC. Methods We reviewed the medical records of patients with unresectable PC diagnosed at our institution between May 2013 and January 2022, and identified patients with endoscopically confirmed tumor bleeding who had received PRT. PRT was administered at a total dose of 30 Grays (Gy) in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in a single fraction, and the dose selection was left to the discretion of the attending radiation oncologists. Results During the study period, 2562 patients were diagnosed as having unresectable PC at our hospital, of which 225 (8.8%) developed GIB. Among the 225 patients, 63 (2.5%) were diagnosed as having tumor bleeding and 20 (0.8%) received PRT. Hemostasis was achieved in 14 of the 20 patients (70%) who received PRT, and none of these patients developed grade 3 or more adverse events related to the PRT. The median time to hemostasis was 8.5 days (range 7–14 days). The rebleeding rate was 21.4% (3/14). The median hemoglobin level increased significantly (p < 0.001) from 5.9 to 9.1 g/dL, and the median volume of red blood cell transfusion tended (p = 0.052) to decrease, from 1120 mL (range 280–3360 mL) to 280 mL (range 0–5560 mL) following the PRT. The median overall survival (OS) was 52 days (95% confidence interval [CI] 39–317). Of the 14 patients in whom hemostasis was achieved following PRT, chemotherapy could be started/resumed in seven patients (50%), and the median OS in these patients was 260 days (95% CI 76–not evaluable [NE]). Three patients experienced rebleeding (21.4%), on days 16, 22, and 25, after the start of PRT. Conclusion This study showed that PRT is an effective and safe treatment modality for tumor bleeding in patients with unresectable PC.
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title_short	Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study
url	https://doi.org/10.1186/s13014-023-02367-5 https://doaj.org/article/f5e2e82d53b14455a922f792aac2eb6e https://doaj.org/toc/1748-717X
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Palliative radiotherapy (PRT) could be promising, however, there are few reports of PRT for tumor bleeding in patients with unresectable PC. Therefore, we evaluated the outcomes of PRT for tumor bleeding in patients with unresectable PC. Methods We reviewed the medical records of patients with unresectable PC diagnosed at our institution between May 2013 and January 2022, and identified patients with endoscopically confirmed tumor bleeding who had received PRT. PRT was administered at a total dose of 30 Grays (Gy) in 10 fractions, 20 Gy in 5 fractions, or 8 Gy in a single fraction, and the dose selection was left to the discretion of the attending radiation oncologists. Results During the study period, 2562 patients were diagnosed as having unresectable PC at our hospital, of which 225 (8.8%) developed GIB. Among the 225 patients, 63 (2.5%) were diagnosed as having tumor bleeding and 20 (0.8%) received PRT. Hemostasis was achieved in 14 of the 20 patients (70%) who received PRT, and none of these patients developed grade 3 or more adverse events related to the PRT. The median time to hemostasis was 8.5 days (range 7–14 days). The rebleeding rate was 21.4% (3/14). The median hemoglobin level increased significantly (p < 0.001) from 5.9 to 9.1 g/dL, and the median volume of red blood cell transfusion tended (p = 0.052) to decrease, from 1120 mL (range 280–3360 mL) to 280 mL (range 0–5560 mL) following the PRT. The median overall survival (OS) was 52 days (95% confidence interval [CI] 39–317). Of the 14 patients in whom hemostasis was achieved following PRT, chemotherapy could be started/resumed in seven patients (50%), and the median OS in these patients was 260 days (95% CI 76–not evaluable [NE]). Three patients experienced rebleeding (21.4%), on days 16, 22, and 25, after the start of PRT. Conclusion This study showed that PRT is an effective and safe treatment modality for tumor bleeding in patients with unresectable PC.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Palliative radiotherapy</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Bleeding</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Pancreatic cancer</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Hemostasis</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Medical physics. Medical radiology. Nuclear medicine</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Neoplasms. Tumors. Oncology. 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Palliative radiotherapy for tumor bleeding in patients with unresectable pancreatic cancer: a single-center retrospective study

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