Self-expanding segmental radioactive metal stents for palliation of malignant esophageal strictures

Bi, Yonghua; Li, Jindong; Yi, Mengfei; Yu, Zepeng; Han, Xinwei; Ren, Jianzhuang

doi:10.1177/0284185119886315

Cited by 12 publications

(9 citation statements)

References 21 publications

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“…The insertion of SEMSs is usually used in the palliative treatment of malignant esophageal stricture in patients with recurrent or advanced esophageal cancer (8)(9)(10). Fully covered SEMSs have been used as a means of alternative management for esophageal perforation and fistula (19)(20)(21), as well as a salvage therapy for patients with esophageal variceal bleeding caused by cirrhosis (11,12,22,23).…”

Section: Discussionmentioning

confidence: 99%

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Compression hemostasis using fully covered self-expandable metallic stents for refractory hemorrhages caused by esophageal cancer: A pilot study

Ren²,

Han³

2023

Front. Gastroenterol.

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ObjectiveFully covered self-expandable metallic stents (SEMSs) have been widely used as a salvage therapy for patients with esophageal variceal bleeding. However, the role of fully covered SEMSs in the management of hemorrhage caused by esophageal cancer has not yet been established. We aimed to investigate the safety and efficacy of fully covered SEMSs as a salvage therapy for esophageal cancer-related hemorrhage.MethodsFrom September 2019 to March 2022, 17 patients, who underwent the insertion of fully covered SEMS for malignant esophageal hemorrhages, were retrospectively analyzed. Chest computed tomography (CT) scans and esophagographies were performed routinely to determine the location and length of the tumor. A fully covered SEMS was implanted under fluoroscopy. Baseline demographics were retrospectively collected, that is those for sex, age, previous treatment, comorbidities, lesion type, and stent size.ResultsA total of 20 metal stents were placed in 17 patients, with a technical success rate of 100% and a hemostasis success rate of 88.2%. Stent removal was performed in three patients because of complications. No perioperative deaths were related to stent placement or removal. Five main complications (29.4%) were found after stent insertion. Stent migration and restenosis were observed in two patients (11.8%). Except for two perioperative deaths and one patient lost to follow-up, all remaining 14 patients were successfully followed up. At the end of follow-up, two patients had survived without obvious symptoms, and a total of 12 patients were dead owing to tumor progression (n = 10), severe infection (n = 1), and cerebrovascular accident (n = 1). The median overall survival was 13.8 months.ConclusionInsertion of a fully covered SEMS may be a safe and effective means of the salvage management of refractory esophageal cancer-related hemorrhage, and its use in this context may lead to the development of innovative methods for compression hemostasis. However, further study with a larger sample size and comparison with other forms of salvage therapy.

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Section: Discussionmentioning

confidence: 99%

“…Self-expandable metallic stent (SEMS) placement has been served as palliative treatment for advanced esophageal patients with esophageal fistula or stricture (8)(9)(10). Fully covered SEMSs have been widely used as a salvage therapy for patients with esophageal variceal bleeding (11,12).…”

Section: Introductionmentioning

confidence: 99%

Compression hemostasis using fully covered self-expandable metallic stents for refractory hemorrhages caused by esophageal cancer: A pilot study

Ren²,

Han³

2023

Front. Gastroenterol.

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“…Minimally invasive treatment using interstitial puncture and the implantation of iodine-125 seeds has become a common clinical technique for the treatment of various solid malignancies ( 15 ), such as oral and maxillofacial malignant tumors ( 16 ). However, it remains unclear whether malignant tumors of cavity organs such as ureteral carcinoma can be treated by radioactive seeds brachytherapy, although cavity organs such as esophageal cancer have been treated with low-dose-rate brachytherapy with radioactive stent ( 17 ) and nutrient tube ( 7 ). It has also been reported that iodine-125 seeds loading inside the catheter to form a seed strand structure to treat malignant bile duct obstruction ( 18 , 19 ) and portal vein tumor thrombus ( 20 ) showed satisfactory clinical results.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of iodine-125 seed strand for intraluminal brachytherapy on ureteral carcinoma

Jiao

Zhang

et al. 2023

Front. Oncol.

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ObjectiveOur aim is to evaluate the safety and efficacy of iodine-125 seed strand for intraluminal brachytherapy on ureteral carcinoma.MethodsFrom November 2014 to November 2021, 22 patients with ureteral cancer not suitable for surgical resection were enrolled. Iodine-125 seed strand was inserted under c-arm CT and fluoroscopic guidance. The technical success rate, complications, disease control rate, and survival time were evaluated. Hydronephrosis Girignon grade and ureteral cancer sizes before and after treatment were compared.ResultsA total of 46 seed strands were successfully inserted and replaced, with a technical success rate of 100% and median procedure time of 62 min. No procedure-related death, ureteral perforation, infection, or severe bleeding occurred. Minor complications were observed in eight (36.4%) patients, and migration of seed strand was the most common complication. Six months after seed strand brachytherapy, one complete response, three partial responses, and five stable diseases were evaluated, and the disease control rate was 64.3%. The Girignon grade of hydronephrosis was significantly improved 1 to 3 months after seed strand insertion. Disease control rates were 94.4, 62.5, and 64.3% at 1-, 3-, and 6-month follow-up. Twenty patients were successfully followed up, with a mean follow-up of 18.0 ± 14.5 months. The median overall survival and progress-free survival were 24.7 and 13.0 months, respectively.ConclusionIodine-125 seed strand is safe and effective for intraluminal brachytherapy and can be used as an alternative to patients with ureteral carcinoma who are not suitable for surgical resection or systemic combined therapy.

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“…However, implantation of a simple stent into the esophagus only temporarily solves the problem of an esophagogastric anastomotic stricture and does not treat the primary disease. In a study by Bi and coworkers ( 31 ), 22 patients with a malignant esophageal stricture underwent implantation of a segmental radioactive metal stent into the esophagus and, compared with patients implanted with a traditional esophageal metal stent, survived longer. Tinusz and collaborators ( 32 ) reported that, after implantation of a radioactive stent into the esophagus in 1177 patients, compared with the traditional esophageal stent, it had more advantages for reversing dysphagia and prolonging the life expectancy of patients.…”

Section: Discussionmentioning

confidence: 99%

Arterial Infusion Chemotherapy for Neoplastic Esophagogastric Anastomotic Strictures After Esophagectomy

Xie

Yin

et al. 2021

Front. Oncol.

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BackgroundNeoplastic esophagogastric anastomotic strictures after resection of esophageal cancer is a very difficult problem in clinical practice. We aim at to investigate the safety and feasibility of arterial infusion chemotherapy in treatment of neoplastic esophagogastric anastomotic strictures after esophagectomy.MethodsFrom October 2014 to December 2019, 50 patients with Neoplastic esophagogastric anastomotic strictures after resection of esophageal cancer were assessed retrospectively. Preoperative dysphagia was grade III in 34 cases and grade IV in 16 cases. Thirty-eight patients had different degrees of dyspnea before surgery Twenty-five patients had intolerable (grade IV) dyspnea and airway stenting was undertaken before surgery. Thirteen patients had tolerable dyspnea that did not require airway stenting, and preoperative dyspnea was grade III.ResultsAll patients were successfully treated with arterial infusion chemotherapy, no paraplegia or death occurred. The dysphagia grade of 50 patients after AIC was compared: one case had grade I, 40 cases had grade II, and nine cases had grade III. Thirteen patients had tolerable dyspnea that did not necessitate airway stenting. Dyspnea was classified as grade I in five cases and grade II in eight cases. After 1–3 courses of AIC, 50 patients were followed up for a complete response (eight cases), partial response (28) and stable disease (14 cases). Total objective effective rate (complete response+ partial response) and disease control rate(complete response + partial response + stable disease)were 72.0% and 100.0%, respectively. The median duration of follow-up was 8.5 months. One-year survival was 46.0%.ConclusionArterial infusion chemotherapy is safe and efficacious treatment for Neoplastic esophagogastric anastomotic strictures after esophagectomy.

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Self-expanding segmental radioactive metal stents for palliation of malignant esophageal strictures

Cited by 12 publications

References 21 publications

Compression hemostasis using fully covered self-expandable metallic stents for refractory hemorrhages caused by esophageal cancer: A pilot study

Compression hemostasis using fully covered self-expandable metallic stents for refractory hemorrhages caused by esophageal cancer: A pilot study

Safety and efficacy of iodine-125 seed strand for intraluminal brachytherapy on ureteral carcinoma

Arterial Infusion Chemotherapy for Neoplastic Esophagogastric Anastomotic Strictures After Esophagectomy

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