Self-expandable covered metallic esophageal stent impregnated with beta-emitting radionuclide: an experimental study in canine esophagus

Won, Jong Uk; Lee, Jong Doo; Wang, Hee Jung; Kim, Gui-Eon; Kim, Bong-Wan; Yim, Hyunee; Han, Sang Keon; Park, Chan H.; Joh, Chul-Woo; Kim, Kyung-Hwa; Park, Kyung Bae; Shin, Kyong-Min

doi:10.1016/s0360-3016(02)02837-7

Cited by 41 publications

(16 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Won et al reported that a self-expandable covered metallic stent impregnated with the hemitting radionuclide 166 Ho can be safely used as an intraluminal brachytherapy for esophageal cancer (22). The same method was used to produce radioactive stents with different dosages implanted into the common bile duct of dogs (23).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Novel Approach for Treatment of Unresectable Pancreatic Cancer: Design of Radioactive Stents and Trial Studies on Normal Pigs

Liu

Cai

et al. 2007

Clinical Cancer Research

View full text Add to dashboard Cite

Purpose: Patients diagnosed with pancreatic cancer typically have a poor prognosis.The aims of these studies were to design radioactive stents and to evaluate the feasibility and safety of the stents in animals. Experimental Design: To combine the effects of stents and brachytherapy, plastic stents with inserted iodine-125 seeds were designed and tested in 18 normal pigs.The pigs were divided into five groups on the basis of radiation dose. The estimated radiation dose at a 5-mm radial distance from the axis of the seeds was 50 Gy in group A, 100 Gy in group B, 150 Gy in group C, and 200 Gy in group D, with four pigs in each group. In the control group (n = 2), the same plastic stents with non-radioactive seeds were implanted in the pancreatic duct. Results: The procedures were successfully done on 14 of 18 (78%) pigs, whereas pancreatic duct perforation occurred in four pigs (22%). The thickened wall of the dilated pancreatic duct was clearly observed in the control group. However, the normal morphologic structure of the pancreatic duct wall disappeared in the experimental groups. Histopathologic examination revealed that the stents were surrounded with necrotic tissues and lateral fibrous tissues. During the follow-up period, the width of outside fibrous tissues gradually increased. Conclusions: These results indicate that the radioactive stents are safe in all dose groups, and it is feasible to design a special radioactive stent for each patient according to the size, shape, and position of the pancreatic tumor.Pancreatic cancer is an uncommon disease that is generally diagnosed at an advanced stage. Surgical resection is currently considered to be the best treatment, but the majority of patients are not suitable for curative resection due to advanced disease at diagnosis, poor patient condition, and/or tumor location (1, 2). Moreover, the life expectancy of pancreatic cancer patients is short; thus, the therapeutic goal is often palliative. An endoscopic procedure combined with chemoradiotherapy is currently used in the treatment of unresectable pancreatic cancer. Palliative surgery and endoscopic drainage can be done for the treatment of obstructive jaundice and other symptoms (1, 3). Drainage with stents in the bile duct and the pancreatic duct has become a favored palliative drainage procedure.Radiotherapy with either external beam, intraluminal brachytherapy, or interstitial brachytherapy has been found to be effective to improve local control in patients with advanced pancreatic cancer (4 -6). The combination of intraluminal brachytherapy and stent drainage seems to be effective in preventing local tumor growth and suitable for patients with poor performance status.To combine the effects of both stents and brachytherapy for preventing local tumor growth, special plastic stents were designed with inserted g-emitting iodine-125 ( 125 I) seeds. The purpose of this study was to evaluate the safety and tissue response following the placement of the radioactive stents in normal porcine pancreatic duc...

show abstract

Section: Discussionmentioning

confidence: 99%

“…Therefore, prior radioactive stents should be tested in the laboratory environment (22,23). According to the location of pancreatic cancer in a patient's computerized tomography scan, a special treatment plan can be formulated for the patient through treatment planning system.…”

Section: Discussionmentioning

confidence: 99%

A Novel Approach for Treatment of Unresectable Pancreatic Cancer: Design of Radioactive Stents and Trial Studies on Normal Pigs

Liu

Cai

et al. 2007

Clinical Cancer Research

View full text Add to dashboard Cite

show abstract

“…There are many advantages to SEMS, and these include the following: easy insertion, with success rate for placement of almost 100% 5,18,20,31,35,36,37,38,40 , large internal diameter, low risk of perforation of the esophagus during the procedure, it can be used as a sole therapy and be inserted in stenoses without the need for excessive dilation of the organ, it adapts better to angled stenoses due to its malleability, it requires conscious sedation of the patient, and in general, palliation of dysphagia occurs immediately in the majority of cases. SEMS is also effective when coated occluding tracheo-esophageal fistulas with a success rate between 70% and 100% 30,37,42 .…”

Section: Discussionmentioning

confidence: 99%

Assesment of placement of the esophageal self-expandable metallic stent in esophageal cancer in patients with or without citorreduction therapy

Kamiyama

Sakai

Moura

et al. 2007

ABCD, arq. bras. cir. dig.

View full text Add to dashboard Cite

BACKGROUND: Placement of self-expanding metallic esophageal stent in patients with advanced esophageal cancer offers excellent palliation of dysphagia and tracheo-esophageal fistulas. However, the safety of stent in patients undergoing radio and/or chemotherapy is controversial, in terms of the greater risk of complications in cases where these two treatments are used in conjunction. AIM: To assess the use of stent in patients with advanced cancer of the mid-thoracic esophagus, by comparing patients undergoing cytoreductive therapy with patients who have not undergone this treatment, in relation to improvement in the dysphagia, rate of complications, period of effectiveness and survival time. METHODS: Fifty seven patients were evaluated retrospectively (16 women and 41 men, with an average age 62 years) with advanced squamous cell carcinoma of the mid-thoracic esophagus who underwent placement of the Ultraflex™ self-expandable metallic coated stent, at the Gastrointestinal Endoscopy Unit of São Paulo University Medical School between October 1988 and October 2004. Out of the 57 patients, 24 patients received adjuvant cytoreductive therapy, and 33 patients were only treated with the stent placement. RESULTS: After stent placement, there was improvement in dysphagia in both groups; there were no differences in the rate of complications, such as migration, pain, fistula, obstruction and compression of the airways; the period of effectiveness was significantly higher in the group submitted to cytoreductive therapy (average 123 days compared to 63 days), as was the survival time (average of 210 days, compared with 120 days). CONCLUSIONS: Improvement in dysphagia was statistically significant in both groups, irrespective of whether the patient had undergone adjuvant cytoreductive therapy; there were no differences in the rate of complications between the two groups and both the period of effectiveness of the stent treatment and the survival time were higher in the group with adjuvant cytoreductive therapy.

show abstract

“…La charge d'une prothèse en isotope pour réaliser une brachythérapie ou intracavitaire [35] a été déterminée chez le chien, permettant de retenir une charge de 1 à 1,8 mCi comme dose optimale, celle de plus de quatre et de moins de 0,7 mCi étant associée à la 12 e semaine, respectivement à 20 % de perforation ; à aucune modification histologique dans 30 % des cas. Le recours à une brachythérapie ou intracavitaire sur prothèse oesophagienne a également été testé chez 27 patients dans un essai contrôlé, les prothèses mises en place sous scopie étant chargées en Iode 125 délivrant 7,7 cGy par heure [36] : une récidive de la sténose tumorale est survenue après un délai respectif de 4,5 vs 2,0 mois dans 8/27 vs 6/26 cas avec une médiane de survie de sept vs quatre mois.…”

Section: Perspectivesunclassified

Vidéo-Digest 20e édition État de l’art en endoscopie digestive: « Les prothèses à tous les étages »

2009

Acta Endosc

View full text Add to dashboard Cite

L'indication majeure des prothèses oesophagiennes sont les sténoses malignes du tiers moyen, du tiers infé-rieur et même du tiers supérieur accessible au traitement endoscopique avec des résultats satisfaisants. Bien qu'il existe une multitude de matériel disponible, l'incertitude réside dans l'heure de la pose de cette prothèse, dans la stratégie de prise en charge globale de patients récusés dans 80 à 90 % des cas pour un traitement chirurgical. Cependant, la durée et le délai de la mise en place des prothèses par rapport à la radiochimiothérapie nécessite probablement encore quelques précisions. Concernant les sté-noses bénignes, deux types de prothèses sont à l'étude, mais il est trop tôt actuellement pour pouvoir formuler une recommandation, les premiers résultats montrant un taux de récidive à court ou à long terme de l'ordre de plus de 50 %, signifiant certainement que la prothèse optimale n'est pas encore disponible pour la pratique quotidienne. Le traitement des fistules oesomédiastinales ou oesotrachéobronchiques est une indication élective de la mise en place de prothèses oesophagiennes, qui en cas de fistules oesorespiratoires doivent faire appel le plus souvent à la double prothèse digestive et respiratoire. La fistule oesomédiastinale iatrogène après endoscopie ou après désunion anastomotique postopératoire constitue également une indication de choix réservé cependant à des Centres Experts et Tertiaires, tant les résultats dans cette indication sont actuellement, bien qu'encourageants, encore peu nombreux.

show abstract

Self-expandable covered metallic esophageal stent impregnated with beta-emitting radionuclide: an experimental study in canine esophagus

Cited by 41 publications

References 29 publications

A Novel Approach for Treatment of Unresectable Pancreatic Cancer: Design of Radioactive Stents and Trial Studies on Normal Pigs

A Novel Approach for Treatment of Unresectable Pancreatic Cancer: Design of Radioactive Stents and Trial Studies on Normal Pigs

Assesment of placement of the esophageal self-expandable metallic stent in esophageal cancer in patients with or without citorreduction therapy

Vidéo-Digest 20e édition État de l’art en endoscopie digestive: « Les prothèses à tous les étages »

Contact Info

Product

Resources

About