a Department of Interventional Oncology , The First Affiliated Hospital, Sun Yat-Sen University , Guangzhou , China.
Int J Hyperthermia. 2017 Nov;33(7):853-861. doi: 10.1080/02656736.2017.1309580. Epub 2017 Apr 10.
To retrospectively evaluate the added benefit of adding intraluminal radiofrequency ablation (RFA) to biliary metal stent placement for patients with malignant biliary obstruction (MBO).
From November 2013 to December 2015, 89 patients with MBO who had undergone percutaneous intraluminal RFA and stent placement (RFA-stent group, n = 50) or stent placement only (stent group, n = 39) were included. Outcomes were compared according to the type of tumour: cholangiocarcinoma or non-cholangiocarcinoma.
Primary and secondary stent patency (PSP, SSP) were significantly higher for the RFA-stent group than the stent group (PSP: 7.0 months vs. 5.0 months, p = 0.006; SSP: 10.0 months vs. 5.6 months, p < 0.001), with overall survival being comparable (5.0 months vs. 4.7 months, p = 0.068). In subgroup analysis, RFA-stent showed significant PSP benefits compared to stent alone in patients with cholangiocarcinoma (7.4 months vs. 4.3 months; p = 0.009), but with comparable outcomes in patients with non-cholangiocarcinoma (6.3 months vs. 5.2 months; p = 0.266). The SSP was improved in both subgroups (cholangiocarcinoma, 12.6 months vs. 5.0 months, p < 0.001; non-cholangiocarcinoma, 10.3 months vs. 5.5 months, p = 0.013). Technical success and clinical success were not significantly different between the two groups. The rate of complication was higher for the RFA-stent group, but tolerable when compared to the stent group.
Although survival was comparable between the groups, RFA-stent confers therapeutic benefits to patients with MBO in terms of stent patency compared to stent placement alone, especially in those with cholangiocarcinoma.
回顾性评估胆管内射频消融（RFA）联合金属支架置入术治疗恶性胆道梗阻（MBO）患者的临床效果。
本研究纳入了 2013 年 11 月至 2015 年 12 月期间 89 例行经皮胆管内 RFA 联合支架置入术（RFA-支架组，n=50）或单纯支架置入术（支架组，n=39）的 MBO 患者。根据肿瘤类型（胆管癌或非胆管癌）对患者进行分组，并对各组间的治疗结局进行比较。
与支架组相比，RFA-支架组患者的原发性和继发性支架通畅率（PSP、SSP）更高（PSP：7.0 个月 vs. 5.0 个月，p=0.006；SSP：10.0 个月 vs. 5.6 个月，p<0.001），但两组患者的总生存时间无显著差异（5.0 个月 vs. 4.7 个月，p=0.068）。亚组分析显示，与单纯支架置入相比，RFA-支架在胆管癌患者中具有显著的 PSP 获益（7.4 个月 vs. 4.3 个月，p=0.009），但在非胆管癌患者中无明显获益（6.3 个月 vs. 5.2 个月，p=0.266）。两组患者的 SSP 均有所改善（胆管癌：12.6 个月 vs. 5.0 个月，p<0.001；非胆管癌：10.3 个月 vs. 5.5 个月，p=0.013）。两组患者的技术成功率和临床成功率无显著差异。RFA-支架组的并发症发生率较高，但与支架组相比，可耐受。
尽管两组患者的生存情况无显著差异，但与单纯支架置入相比，RFA-支架可改善 MBO 患者的支架通畅率，从而为患者带来获益，尤其是在胆管癌患者中。
