Jiao Dechao, Zhou Xueliang, Li Zongming, Bi Yonghua, Zhang Quanhui, Li Jing, Li Lei, Ren Jianzhuang, Han Xinwei
Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
J Cancer Res Ther. 2020;16(2):286-291. doi: 10.4103/jcrt.JCRT_804_19.
Self.expandable metallic stent (SEMS) placement has been considered as the preferred treatment to relieve jaundice in nonsurgical patients. However, 50% of stents become stenosed within 3.6 months due to tumor ingrowth and epithelial hyperplasia. This study aims to evaluate the feasibility and efficacy of a newly designed brachytherapy biliary drainage catheter (BBDC) loaded with 125I seeds for palliation of malignant biliary obstruction (MBO).
In this prospective study, patients with unresectable MBO underwent BBDC placement after SEMS placement at our center from September 2017 to April 2019.
A total of 21 patients with MBO were enrolled. The technical and clinical success rates were 100%. Total bilirubin, direct bilirubin, alanine aminotransferase, alkaline phosphatase, cancer antigen 19.9, and carcinoembryonic antigen levels significantly decreased during the 1.month follow.up (P < 0.05). Four patients (19%) had minor complications. During the median follow.up of 299 days, 13 patients (61.9%) developed stent occlusion. The 6.month stent patency and survival rates were 73.5% and 79.2%, respectively. The median stent patency and survival were 279 and 454 days, respectively.
The use of BBDC loaded with 125I seeds is a feasible and effective method to prolong biliary stent patency in patients with MBO.
自膨式金属支架（SEMS）置入术被认为是缓解非手术患者黄疸的首选治疗方法。然而，由于肿瘤长入和上皮增生，50%的支架在3.6个月内会发生狭窄。本研究旨在评估一种新设计的装载125I种子源的近距离放射治疗胆道引流导管（BBDC）缓解恶性胆道梗阻（MBO）的可行性和疗效。
在这项前瞻性研究中，2017年9月至2019年4月期间，在我们中心，不可切除的MBO患者在SEMS置入术后接受了BBDC置入。
共纳入21例MBO患者。技术成功率和临床成功率均为100%。在1个月的随访期间，总胆红素、直接胆红素、丙氨酸转氨酶、碱性磷酸酶、癌胚抗原19.9和癌胚抗原水平显著下降（P<0.05）。4例患者（19%）出现轻微并发症。在中位随访299天期间，13例患者（61.9%）发生支架闭塞。6个月时支架通畅率和生存率分别为73.5%和79.2%。支架通畅和生存的中位时间分别为279天和454天。
使用装载125I种子源的BBDC是延长MBO患者胆道支架通畅时间的一种可行且有效的方法。
