Who should receive single-fraction palliative radiotherapy for gastric cancer bleeding?: An exploratory analysis of a multicenter prospective observational study (JROSG 17-3)

• Published in: Clinical and translational radiation oncology 2023-09, Vol.42, p.100657-100657, Article 100657
• Main Authors: Sekii, Shuhei, Saito, Tetsuo, Kosugi, Takashi, Nakamura, Naoki, Wada, Hitoshi, Tonari, Ayako, Ogawa, Hirofumi, Mitsuhashi, Norio, Yamada, Kazunari, Takahashi, Takeo, Ito, Kei, Kawamoto, Terufumi, Araki, Norio, Nozaki, Miwako, Heianna, Joichi, Murotani, Kenta, Hirano, Yasuhiro, Satoh, Atai, Onoe, Tsuyoshi, Shikama, Naoto
• Format: Article
• Language: English
• Subjects: Gastric cancer; Original; Palliative treatment; Radiotherapy
• ISSN: 2405-6308; 2405-6308
• DOI: 10.1016/j.ctro.2023.100657

•PPI predicts  2.•Re-irradiation for rebleeding to be considered for longer survival than predicted. Although the Palliative Prognostic Index (PPI) has been used to predict survival in various cancers, to our knowledge, no study has examined its applicability in gastric cancer. This study aimed to determine the baseline PPI cutoff value for recommending single-fraction radiotherapy in patients with bleeding gastric cancer. This was a secondary analysis of the Japanese Radiation Oncology Study Group (JROSG) 17–3, a multicenter prospective study of palliative radiotherapy for bleeding gastric cancer. Discrimination was evaluated using a time-dependent receiver operating characteristic curve, and the optimal cutoff value was determined using the Youden index. A calibration plot was used to assess the agreement between predicted and observed survival. We enrolled 55 patients in JROSG 17–3. The respective median survival times were 6.7, 2.8, and 1.0 months (p = 0.021) for patients with baseline PPI scores of ≤ 2, 2  4. The areas under the curve for predicting death within 2, 3, 4, and 5 months were 0.813, 0.787, 0.775, and 0.721, respectively. The negative predictive value was highest when survival