Hemostatic Radiotherapy – A Retrospective Audit from  a Tertiary Cancer Centre in South India

Gautam Vydia Vedagiri; Ramanaiah Kaluvoya; Surjith K; Arun Kumar M N; Vengadakrishnan Vengadakrishnan

doi:10.31557/apjec.1892.20250910

Authors

Gautam Vydia Vedagiri Radiation Oncologist, Department of Radiation Oncology, Cancer Institute, Adyar, India.
Ramanaiah Kaluvoya Radiation Oncologist, Department of Radiation Oncology, Cancer Institute, Adyar, India.
Surjith K Radiation Oncologist, Department of Radiation Oncology, Cancer Institute, Adyar, India.
Arun Kumar M N Radiation Oncologist, Department of Radiation Oncology, Cancer Institute, Adyar, India.
Vengadakrishnan Vengadakrishnan Radiation Oncologist, Department of Radiation Oncology, Cancer Institute, Adyar, India.

DOI:

https://doi.org/10.31557/apjec.1892.20250910

Keywords:

Tumor-related bleeding, Radiotherapy (RT), Hemostasis, Emergency intervention, Retrospective analysis, Cobalt beam therapy

Abstract

Background: Tumor-related bleeding is a life-threatening complication of cancer, necessitating immediate intervention. Radiotherapy (RT) serves as an effective non-invasive method to achieve hemostasis. This study evaluates the outcomes of hemostatic RT at our institution, highlighting its success in resource-limited settings.

Methods: A retrospective analysis was conducted on 38 patients who received hemostatic RT for tumor-related bleeding between 2013 and 2023. The primary endpoint was hemostasis, defined as the cessation or stabilization of bleeding. Secondary endpoints included overall survival (OS) and treatment-related toxicity. The most common RT regimen was 500 cGy per fraction over two fractions (total dose: 10 Gy), using cobalt-based therapy or 6 MV X-rays.

Results: Hemostasis was achieved in 89% of patients (n = 34). The median OS was 6 months (range: 1.5–9 months), with survival varying by tumor type. No grade 3 or higher acute toxicities were observed. Parotid carcinoma patients had the longest survival (9 months), whereas plasma cell leukemia had the shortest (1.5 months). The study underscores the effectiveness of hypofractionated RT in achieving hemostasis, especially in LMICs where cobalt therapy remains a critical resource.

Conclusion: Our findings reaffirm the efficacy of hypofractionated RT in controlling tumor-related bleeding with minimal toxicity. This study emphasizes the importance of RT as a cost-effective and accessible treatment option in LMICs, advocating for further research into optimizing fractionation schedules and integrating systemic therapies.