A novel biliary stent loaded with 125I seeds in patients with malignant biliary obstruction: Preliminary results versus a conventional biliary stent

Zhu, Hai-Dong; Guo, Jun; Zhu, Guangyu; He, Shi-Cheng; Fang, Wen; Deng, Gang; Qin, Yuan; Guozhao, Li; Coldwell, Douglas M.; Teng, Gao‐Jun

doi:10.1016/j.jhep.2011.12.018

Cited by 90 publications

(90 citation statements)

References 35 publications

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“…Some researches has shown that peform PTBS for patients with malignant obstructive jaundice combined with anti-tumor treatment could significantly prolong stent patency and survival time (Qian et al, 2006). This study shows that the mean reobstructiive time in combination group is 125 days, significantly longer (Todoroki T et al, 2000;Simmons et al, 2006;Zhu et al, 2012). Interventional drainage in the treatment of the obstructive jaundice caused by recurrence and metastasis after tumor resection can decrease bilirubin level quickly in a short period and promote the liver function recovery.…”

Section: Discussionmentioning

confidence: 79%

Drainage Alone or Combined with Anti-tumor Therapy for Treatment of Obstructive Jaundice Caused by Recurrence and Metastasis after Primary Tumor Resection

Huang²,

Wang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Aim: To compare drainage alone or combined with anti-tumor therapy for treatment of obstructive jaundice caused by recurrence and metastasis after primary tumor resection. Materials and Methods: We collect 42 patients with obstructive jaundice caused by recurrence and metastasis after tumor resection from January 2008 -August 2012, for which percutaneous transhepatic catheter drainage (pTCD)/ percutaneous transhepatic biliary stenting (pTBS) were performed. In 25 patients drainage was combined with anti-tumor treatment, antineoplastic therapy including intra/postprodure local treatment and postoperative systemic chemotherapy, the other 17 undergoing drainage only. We assessed the two kinds of treatment with regard to patient prognosis. Results: Both treatments demonstrated good effects in reducing bilirubin levels in the short term and promoting liver function. The time to reobstruction was 125 days in the combined group and 89 days in the drainage only group; the mean survival times were 185 and 128 days, the differences being significant. Conclusions: Interventional drainage in the treatment of the obstructive jaundice caused by recurrence and metastasis after tumor resection can decrease bilirubin level quickly in a short term and promote the liver function recovery. Combined treatment prolongs the survival time and period before reobstruction as compared to drainage only.

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Section: Discussionmentioning

confidence: 79%

Drainage Alone or Combined with Anti-tumor Therapy for Treatment of Obstructive Jaundice Caused by Recurrence and Metastasis after Primary Tumor Resection

Huang²,

Wang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Zhu et al . [6] were the first to report encouraging results with its clinical application. However, seed activity, reference point of prescription dose, and the irradiation dose of target were different in the related studies.…”

Section: Introductionmentioning

confidence: 99%

In vitro Dosimetric Study of Biliary Stent Loaded with Radioactive 125I Seeds

Yao

Wang

Shang

et al. 2017

Chinese Medical Journal

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Background:A novel radioactive 125I seed-loaded biliary stent has been used for patients with malignant biliary obstruction. However, the dosimetric characteristics of the stents remain unclear. Therefore, we aimed to describe the dosimetry of the stents of different lengths — with different number as well as activities of 125I seeds.Methods:The radiation dosimetry of three representative radioactive stent models was evaluated using a treatment planning system (TPS), thermoluminescent dosimeter (TLD) measurements, and Monte Carlo (MC) simulations. In the process of TPS calculation and TLD measurement, two different water-equivalent phantoms were designed to obtain cumulative radial dose distribution. Calibration procedures using TLD in the designed phantom were also conducted. MC simulations were performed using the Monte Carlo N-Particle eXtended version 2.5 general purpose code to calculate the radioactive stent's three-dimensional dose rate distribution in liquid water. Analysis of covariance was used to examine the factors influencing radial dose distribution of the radioactive stent.Results:The maximum reduction in cumulative radial dose was 26% when the seed activity changed from 0.5 mCi to 0.4 mCi for the same length of radioactive stents. The TLD's dose response in the range of 0–10 mGy irradiation by 137Cs γ-ray was linear: y = 182225x − 6651.9 (R2= 0.99152; y is the irradiation dose in mGy, x is the TLDs’ reading in nC). When TLDs were irradiated by different energy radiation sources to a dose of 1 mGy, reading of TLDs was different. Doses at a distance of 0.1 cm from the three stents’ surface simulated by MC were 79, 93, and 97 Gy.Conclusions:TPS calculation, TLD measurement, and MC simulation were performed and were found to be in good agreement. Although the whole experiment was conducted in water-equivalent phantom, data in our evaluation may provide a theoretical basis for dosimetry for the clinical application.

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“…Zhu et al [19] found no incidence of stent migration when they treated biliary malignancy with intraluminal radiotherapy, but this may be due to their use of a stent-in-stent configuration. Engineer et al [13] concluded that endobiliary stents were stable tumour surrogates during EBRT after they found population mean position changes of less than 0.4 cm in all directions during EBRT.…”

Section: Discussionmentioning

confidence: 99%

Endobiliary Stent Position Changes during External-beam Radiotherapy

Chu

Eccles

Brunner

2015

Journal of Medical Imaging and Radiation Sciences

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PurposeEndobiliary stents can be used as surrogates for pancreatic localization when using cone-beam computed tomography (CBCT) during external-beam radiotherapy (EBRT). This work reports on interfraction stent position changes during EBRT for locally advanced pancreatic cancer (LAPC).Materials and MethodsSix patients with endobiliary stents who underwent EBRT for LAPC were assessed. Measurements from the most superior aspect of the stent (sup stent) and the most inferior aspect of the stent (inf stent) to the most inferior, posterior aspect of the L1 vertebra central spinous process were determined from daily treatment CBCTs and compared with those determined from the planning computed tomography (CT) scan. Changes in stent-L1 measurements were interpreted as changes in relative stent position.ResultsThree patients showed mean interfraction stent position changes of ≥1 cm when treatment measurements were compared with planning measurements. The sup stent for patient A moved to the right (2.66 ± 2.77 cm) and inferiorly (3.0 ± 3.12 cm), and the inf stent moved to the right (1.92 ± 2.02 cm) inferiorly (3.23 ± 3.34 cm) and posteriorly (1.41 ± 1.43 cm). The inf stent for patient B moved superiorly (2.23 ± 0.49 cm) and posteriorly (1.72 ± 0.59 cm). The sup and inf stent for patient F moved inferiorly (0.98 ± 0.35 cm and 1.21 ± 0.38 cm, respectively). The remaining three patients C, D, and E showed interfraction position changes of <1 cm.ConclusionEndobiliary stent migration and deformation were observed in a small subset of patients. Further investigation is required before confirming their use as surrogates for LAPC target localization during image-guided EBRT.

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A novel biliary stent loaded with 125I seeds in patients with malignant biliary obstruction: Preliminary results versus a conventional biliary stent

Cited by 90 publications

References 35 publications

Drainage Alone or Combined with Anti-tumor Therapy for Treatment of Obstructive Jaundice Caused by Recurrence and Metastasis after Primary Tumor Resection

Drainage Alone or Combined with Anti-tumor Therapy for Treatment of Obstructive Jaundice Caused by Recurrence and Metastasis after Primary Tumor Resection

In vitro Dosimetric Study of Biliary Stent Loaded with Radioactive 125I Seeds

Endobiliary Stent Position Changes during External-beam Radiotherapy

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