Jiao Dechao, Xu Kaihao, Mukhiya Gauri, Liu Yiming, Wu Kunpeng, Li Zongming, Ren Jianzhuang, Han Xinwei
Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Oncol. 2022 Jul 14;12:941336. doi: 10.3389/fonc.2022.941336. eCollection 2022.
Most patients with advanced pancreatic cancer do not have the chance to undergo surgery or chemotherapy because of their poor conditions. Biliary drainage is a palliative treatment to restore liver function and alleviate jaundice, but most patients still face the risk of biliary obstruction in the short term after operation. The purpose of this study is to evaluate the efficacy and safety of brachytherapy drainage catheter (BDC)-combined chemotherapy in the treatment of pancreatic cancer complicated with obstructive jaundice.
From November 2017 and May 2019, 48 patients underwent the BDC or conventional drainage catheter (CDC) intervention with chemotherapy. The outcomes/endpoints analyzed were technical and clinical success, early complications, stent patency period, and survival.
The technical and clinical success rates in both groups were 100%, and the early complication rates were not significantly different (P = 0.43). The median stent patency in the BDC group was significantly longer than that in the CDC group (7.8 ± 1.5 vs. 5.7 ± 0.7 months, P = 0.001), and the median overall survival period in the BDC group was prone to significant difference than that in the CDC group (9.4 ± 4.0 vs. 8.2 ± 0.3 months, P = 0.089).
The findings of this study show that BDC with chemotherapy was associated with better stent patency and survival. However, since the sample size was very small, large randomized controlled multicenter studies are needed to further evaluate the long-term survival effects of BDC in patients with advanced pancreatic carcinoma combined with obstructive jaundice.
大多数晚期胰腺癌患者因身体状况不佳而没有机会接受手术或化疗。胆管引流是一种恢复肝功能和减轻黄疸的姑息性治疗方法，但大多数患者在术后短期内仍面临胆管阻塞的风险。本研究的目的是评估近距离放射治疗引流导管（BDC）联合化疗治疗胰腺癌合并梗阻性黄疸的疗效和安全性。
2017年11月至2019年5月，48例患者接受了BDC或传统引流导管（CDC）干预并化疗。分析的结局/终点指标包括技术和临床成功率、早期并发症、支架通畅期和生存率。
两组的技术和临床成功率均为100%，早期并发症发生率无显著差异（P = 0.43）。BDC组的支架中位通畅时间明显长于CDC组（7.8±1.5个月对5.7±0.7个月，P = 0.001），BDC组的中位总生存期与CDC组相比有显著差异倾向（9.4±4.0个月对8.2±0.3个月，P = 0.089）。
本研究结果表明，BDC联合化疗可使支架通畅性和生存率更佳。然而，由于样本量非常小，需要开展大型随机对照多中心研究，以进一步评估BDC对晚期胰腺癌合并梗阻性黄疸患者的长期生存效果。
