Department of Interventional Radiology, Ningbo First Hospital, Ningbo.
Department of Interventional Radiology, Jiangyin People's Hospital, Jiangyin, China.
Medicine (Baltimore). 2021 May 28;100(21):e26192. doi: 10.1097/MD.0000000000026192.
To assess effectiveness and safety associated with radioactive stenting for hilar cholangiocarcinoma (HCCA) patients.This single-center retrospective study compared baseline and treatment data of recruited consecutive patients with HCCA underwent either normal or radioactive stenting between January 2016 and December 2019. Clinical success was defined by total bilirubin (TBIL) levels falling below 70% of the preoperative baseline within 2 weeks post stent insertion.Sixty-five patients with inoperable HCCA underwent normal (n = 35) or radioactive (n = 30) stenting at our center. Technical success of both types of the normal and radioactive stent insertion was 100%. Each patient received 1 stent. In the radioactive stent group, each patient received 1 radioactive seed strand (RSS), containing 10 to 12 radioactive seeds. Clinical success rates were 86.8% and 100% in normal and radioactive groups, respectively (P = .495). We observed stent dysfunction in 9 patients (normal group) and 7 patients (radioactive group) (P = .824). Median duration of stent patency was 165 days (normal group) and 226 days (radioactive group) (P < .001). During follow-up, all patients died from tumor progression, with respective median survival of 198 days (normal group) and 256 days (radioactive group) (P < .001). Seven and 5 patients in the normal and radioactive groups suffered from stent-related complications (P = .730).Radioactive stenting is effective and safe for inoperable HCCA patient and may prolong stent patency and survival.
评估放射性支架置入治疗肝门部胆管癌（HCCA）患者的有效性和安全性。本单中心回顾性研究比较了 2016 年 1 月至 2019 年 12 月连续入组的 HCCA 患者在接受常规或放射性支架置入治疗前后的基线和治疗数据。临床成功定义为支架置入后 2 周内总胆红素（TBIL）水平降至术前基线的 70%以下。中心共对 65 例不可切除的 HCCA 患者进行了常规（n=35）或放射性（n=30）支架置入。两种类型的常规和放射性支架置入的技术成功率均为 100%。每位患者均接受 1 个支架。放射性支架组中，每位患者均接受 1 个含有 10 至 12 个放射性粒子的放射性粒子丝（RSS）。常规组和放射性组的临床成功率分别为 86.8%和 100%（P=0.495）。我们观察到 9 例（常规组）和 7 例（放射性组）患者出现支架功能障碍（P=0.824）。支架通畅中位时间分别为 165 天（常规组）和 226 天（放射性组）（P<0.001）。在随访期间，所有患者均因肿瘤进展而死亡，中位生存时间分别为 198 天（常规组）和 256 天（放射性组）（P<0.001）。常规组和放射性组各有 7 例和 5 例患者发生支架相关并发症（P=0.730）。放射性支架置入治疗不可切除的 HCCA 患者是有效且安全的，可能延长支架通畅时间和生存时间。
