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放射性种子strand 在非小细胞肺癌阻塞引起的上腔静脉支架置入术中的疗效。

Radioactive Seed Strand Efficacy in Superior Vena Cava Stenting Due to Non-small-cell Lung Cancer Obstruction.

机构信息

Department of Vascular Surgery, 159434Xuzhou Central Hospital, Xuzhou, China.

Department of Radiology, 159434Xuzhou Central Hospital, Xuzhou, China.

出版信息

Vasc Endovascular Surg. 2022 Feb;56(2):173-179. doi: 10.1177/15385744211054300. Epub 2021 Oct 27.

Abstract

PURPOSE

This study aims to determine the clinical effectiveness of a stent with radioactive seed strand (RSS) inserted in patients with superior vena cava (SVC) obstruction (SVCO) secondary to non-small-cell lung cancer (NSCLC).

METHODS

Between January 2013 and December 2019, 63 patients with SVCO related to NSCLC received stent implantation with (n = 30) or without (n = 33) RSS insertion at our center. The clinical efficacy, stent patency duration, and overall survival (OS) were compared between these two groups.

RESULTS

Both groups achieved 100% clinical and technical success rates. There were no obstacles associated with the procedure performed for the patients. Two patients in the RSS group and 7 patients in the stent-alone group experienced stent re-stenosis. The rate of re-stenosis between the two groups was not significantly different ( = .099). Patients in the RSS group had significantly longer median patency than those in the stent-alone group (381 vs 309 days, = .045). All patients died because of the development of tumors during the follow-up. Patients in the RSS group had a significantly longer median OS than those in the stent-alone group (229 vs 178 days, = .026). During the follow-up, no patient in the RSS group suffered RSS migration or brachytherapy-related complications.

CONCLUSION

For patients with SVCO secondary to NSCLC, a stent with RSS insertion is efficacious and safe, and it may improve stent patency and OS.

摘要

目的

本研究旨在确定放射性种子丝(RSS)支架置入治疗非小细胞肺癌(NSCLC)所致上腔静脉阻塞(SVCO)患者的临床疗效。

方法

2013 年 1 月至 2019 年 12 月,我院收治 63 例 NSCLC 相关 SVCO 患者,其中 30 例行 RSS 支架置入,33 例行单纯支架置入。比较两组患者的临床疗效、支架通畅时间和总生存期(OS)。

结果

两组患者均达到 100%的临床和技术成功率。无与手术相关的并发症。RSS 组 2 例和单纯支架组 7 例发生支架再狭窄。两组再狭窄率无显著差异( =.099)。RSS 组中位通畅时间明显长于单纯支架组(381 天 vs 309 天, =.045)。所有患者均因肿瘤进展而死亡。RSS 组中位 OS 明显长于单纯支架组(229 天 vs 178 天, =.026)。随访期间,RSS 组无患者发生 RSS 移位或放射性粒子治疗相关并发症。

结论

对于 NSCLC 所致 SVCO 患者,RSS 支架置入安全有效,可延长支架通畅时间和 OS。

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