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研究自膨式金属支架管腔内 I 粒子条近距离放射治疗恶性胆道梗阻。

Study of self-expandable metallic stent placement intraluminal I seed strands brachytherapy of malignant biliary obstruction.

机构信息

Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou, 450052, Henan Province, People's Republic of China.

出版信息

Surg Endosc. 2017 Dec;31(12):4996-5005. doi: 10.1007/s00464-017-5481-5. Epub 2017 Jun 22.

DOI:10.1007/s00464-017-5481-5
PMID:28643064
Abstract

OBJECTIVE

To evaluate the safety and efficacy of self-expandable metallic stent placement combined with or without intraluminal I seed strands brachytherapy in patients with malignant biliary obstruction.

METHODS

Participants were randomly assigned to receive treatment with a self-expandable metallic stent (SEMS) placement combined with intraluminal I seed strands brachytherapy (brachytherapy group) or a SEMS without brachytherapy (control group). The outcomes were measured in terms of technical success, clinical success, stent patency, complications related to the procedure, and patient survival. A P value of less than 0.05 indicated a significant difference. Results There were no significant differences in technical and clinical success between brachytherapy and control group (100 vs. 100%-100 vs. 93.3%). During the median 273.4 ± 154.6 days follow-up time, the median stent patency time in the brachytherapy group was longer than those in the control group (368.0 ± 42.4 vs. 220.0 ± 34.8 days), and the duration of survival in the brachytherapy groups was higher than those in the control group (355.0 ± 71.5 vs. 209.0 ± 17.2 days). There were no significant differences in the complications between the two groups. Conclusions SEMS placement combined with intraluminal I seed strands brachytherapy are feasible and effective for malignant biliary obstruction, and seems to prolong the stent patency and survival time.

摘要

目的

评估自膨式金属支架(SEMS)置入联合或不联合腔内碘 125 粒子条近距离放疗治疗恶性胆道梗阻的安全性和有效性。

方法

将参与者随机分为 SEMS 置入联合腔内碘 125 粒子条近距离放疗(近距离放疗组)或单纯 SEMS 置入(对照组)。以技术成功率、临床成功率、支架通畅率、与操作相关的并发症和患者生存情况作为结局指标。P 值小于 0.05 表示差异具有统计学意义。

结果

近距离放疗组和对照组在技术成功率和临床成功率方面无显著差异(100%比 100%-100%比 93.3%)。在中位 273.4±154.6 天的随访时间内,近距离放疗组的中位支架通畅时间长于对照组(368.0±42.4 天比 220.0±34.8 天),近距离放疗组的生存时间长于对照组(355.0±71.5 天比 209.0±17.2 天)。两组并发症发生率无显著差异。

结论

SEMS 置入联合腔内碘 125 粒子条近距离放疗治疗恶性胆道梗阻是可行且有效的,似乎可延长支架通畅时间和生存时间。

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