肝门部恶性梗阻腔内近距离放射治疗的应用：一项回顾性对照研究。
Application of intraluminal brachytherapy for malignant obstruction in the porta hepatis: a retrospective control study.
作者信息
Zhang Yi, Yang Yang, Li Lingling, Li Peimin
机构信息
Department of Interventional Therapy, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China.
Department of Neurology, Luzhou Branch of Changzhi People's Hospital, Changzhi, Shanxi, China.
出版信息
Front Oncol. 2025 May 1;15:1416565. doi: 10.3389/fonc.2025.1416565. eCollection 2025.
PURPOSE AND BACKGROUND
Malignant obstructions in the porta hepatis mainly include malignant obstructive jaundice (MOJ) and portal vein tumor thrombus (PVTT). Stent placement has been one of the most commonly recommended methods to alleviate the physical suffering of these patients, but the long-term outcome has been frustrating in terms of stent occlusion. The aim of this study was to discuss the clinical effect and technical feasibility of intraluminal brachytherapy (ILBT) in patients with malignant obstruction in the porta hepatis.
METHODS AND MATERIALS
From 2016 to 2018, 68 patients diagnosed with malignant obstruction in the porta hepatis were retrospectively included in this study. Twenty-eight patients (group A) received stent placement with iodine-125 seed-strand implantation, and 40 patients (group B) received stent placement only. All patients underwent numerous transarterial chemoembolizations (TACE) after stent implantation. All patients were followed up until death. Clinical data, stent patency and survival time were recorded for further analysis.
RESULTS
There was no significant difference between the two groups in terms of length of malignant obstruction and baseline characteristics. 68 stents were successfully implanted in both groups.Iodine-125 seed strands were successfully deployed and completely covered the length of the stent in group A. Liver function and jaundice improved continuously in the first 9 months after treatment (P<0.05). Compared to group B, the mean stent patency time was significantly longer in group A (5.5 ± 2.09 months versus 6.86 ± 1.82 months, P<0.001). The mean survival time is longer in group A than in patients in group B (10.03 ± 3.04 months VS 7 ± 2.44 months, P<0.001).
CONCLUSION
ILBT in combination with stent implantation and TACE has proven to be a feasible and effective palliative treatment to maintain stent patency in patients with PVTT and MOJ.
目的与背景
肝门部恶性梗阻主要包括恶性梗阻性黄疸（MOJ）和门静脉癌栓（PVTT）。支架置入一直是缓解这些患者身体痛苦最常用的推荐方法之一，但就支架闭塞而言，长期效果并不理想。本研究旨在探讨腔内近距离放疗（ILBT）治疗肝门部恶性梗阻患者的临床疗效和技术可行性。
方法与材料
回顾性纳入2016年至2018年诊断为肝门部恶性梗阻的68例患者。28例患者（A组）接受碘-125粒子链植入支架置入术，40例患者（B组）仅接受支架置入术。所有患者在支架植入后均接受多次经动脉化疗栓塞术（TACE）。所有患者随访至死亡。记录临床资料、支架通畅情况和生存时间以进行进一步分析。
结果
两组在恶性梗阻长度和基线特征方面无显著差异。两组均成功植入68枚支架。A组碘-125粒子链成功置入并完全覆盖支架长度。治疗后前9个月肝功能和黄疸持续改善（P<0.05）。与B组相比，A组支架平均通畅时间显著更长（5.5±2.09个月对6.86±1.82个月，P<0.001）。A组平均生存时间长于B组患者（10.03±3.04个月对7±2.44个月，P<0.001）。
结论
ILBT联合支架置入和TACE已被证明是一种可行且有效的姑息治疗方法，可维持PVTT和MOJ患者的支架通畅。
Zotero 插件