Study of Percutaneous Stent Placement with Iodine-125 Seed Strand for Malignant Biliary Obstruction

Zhou, Wei-Zhong; Fu, Yong-Meng; Yang, Zhigang; Shi, Haibin; Liu, Sheng; Xia, Jun; Zhou, Chun‐Gao

doi:10.1007/s00270-018-2117-7

Cited by 26 publications

(31 citation statements)

References 19 publications

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“…17 A retrospective analysis of 132 patients (95 with biliary obstruction located at the hilar region) who received SEMS with 125 I seeds strand (seeds group) or SEMS alone (control group) for MBO, showed that, compared with controls, treatment with SEMS plus 125 I seeds significantly prolonged median stent patency (194 days versus 86 days, P ¼ 0.049) and median overall survival (194 days versus 96 days, P ¼ 0.031). 28 Similar results were reported in a study comparing radiation emitting metallic stent (REMS) and SEMS in the treatment of Bismuth type III or IV hilar cholangiocarcinoma. 18 The first multicentre, randomized clinical trial, that included a total of 328 patients with Bismuth type I or II MBO who were enrolled from 20 Chinese centres, was conducted to further evaluate the effectiveness of radioactive stents in patients with unresectable hilar MBO.…”

Section: Discussionsupporting

confidence: 78%

“…29 At present, there are three methods for deployment of 125 I seeds: (1) 125 I seeds strand inserted in a drainage catheter; 16 (2) an 125 I seeds-loaded stent; 18,29 and (3) an 125 I seeds strand fixed between SEMS and the bile duct wall. 17,28 The advantage of the first method is replaceability of the 125 I seeds strand, but a disadvantage is the limitation of external biliary drainage. A disadvantage of the second method is the composition of two-layer stents and larger diameter sheath.…”

Section: Discussionmentioning

confidence: 99%

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Biliary self-expandable metallic stent combined with Iodine-125 seeds strand in the treatment of hilar malignant biliary obstruction

Zhou

Huang

et al. 2019

J Int Med Res

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Objective: To assess the safety and effectiveness of a self-expandable metallic stent (SEMS) combined with Iodine-125 seeds strand to treat hilar malignant biliary obstruction (MBO). Methods: This retrospective study included patients who had received SEMS with 125 I seeds strand (seeds group) or SEMS alone (controls) to treat hilar MBO. Demographic, biochemical, stent patency, overall survival and complications data were extracted and analysed. Results: A total of 76 patients were included (seeds group, n ¼ 40; controls, n ¼ 36), with a total of 608 seeds deployed in the seeds group (mean, 15.2 AE 4.1 [range, 8-25] seeds per patient). Statistically significant between-group differences were shown in median stent patency time (seeds group, 387.0 AE 27.9 days [95% confidence interval {CI} 332.4, 441.6] versus controls, 121.0 AE 9.1 days [95% CI 103.2, 138.8]) and in median overall survival (seeds group, 177.0 AE 17.9 days [95% CI 141.8, 212.2] versus controls, 123.0 AE 20.4 [95% CI 83.0, 163.0]). There were no statistically significant between-group differences in complication rates. Conclusion: SEMS combined with 125 I seeds strand is safe, feasible, and tolerable in treating patients with hilar MBO, and may be effective in prolonging stent patency time and overall survival.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Biliary self-expandable metallic stent combined with Iodine-125 seeds strand in the treatment of hilar malignant biliary obstruction

Zhou

Huang

et al. 2019

J Int Med Res

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“…A previous study reported that the catheter loading 125 I seed stripes combined with biliary stent implantation had a good clinical effect on relieving malignant biliary tract obstruction (29). For pancreatic head cancer with biliary obstruction belonging to malignant biliary lesions, this combination was used in this study, and a good effect was also achieved.…”

Section: Discussionmentioning

confidence: 92%

A novel combination of percutaneous stenting with iodine-125 seed implantation and chemotherapy for the treatment of pancreatic head cancer with obstructive jaundice

et al. 2021

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Insertion of radioactive strips through the biliary stent has been reported to offer longer survival and patency than an uncovered conventional self-expanding metal stent in patients with unresectable malignant biliary obstruction. The aim of this study was to investigate the safety and effectiveness of intraluminal brachytherapy combined with 125 I seed implantation and transarterial infusion chemotherapy for the treatment of pancreatic head cancer with obstructive jaundice. METHOD: From October 2012 to January 2018, 21 consecutive patients diagnosed with biliary obstruction caused by locally advanced, nonmetastatic pancreatic cancer with cytologically or histologically confirmed by biopsy were enrolled and receive treatment with intraluminal brachytherapy using 125 I seed strand and CT-guided percutaneous radioactive seed implantation therapy. The procedure-related and radiation complications were assessed. The outcomes were measured in terms of stent patency, patient survival, complications related to the procedure. RESULT: One of the 22 patients (4.5%, 1/22) with pancreatic head cancer failed to perform the above procedure because the guidewire was unable to pass through the obstruction segment. The remaining 21 patients (95.5%, 21/22) with pancreatic head cancer with obstructive jaundice were successfully placed with biliary stents and radioactive strips through drainage tubes. The median number of 125 I seeds loaded was 15, ranging from 12 to 17. After the chemotherapy with gemcitabine and cisplatin, no adverse reaction of Grade III~Ⅳ occurred in all cases. Median stent patency was 12.50 months (95% CI: 10.26, 14.74). By May 2019, all 21 patients had died, with overall survival of 5.2e23.3 months, with a median survival of 13.20 months (95% CI: 10.96, 15.44). CONCLUSION: Percutaneous 125 I seed implantation combined with insertion of radioactive strips through the biliary stent has the characteristics of less trauma, fewer complications, simple operation, and so on. These procedures bring remission of obstructive jaundice combined with the increased survival for the treatment of obstructive jaundice caused by unresectable pancreatic head cancer if follow-up chemotherapy is carried out. The long-term efficacy of this treatment combination needs to be confirmed by further multicenter, large sample size prospective randomized controlled studies.

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“…In the eld of brachytherapy, Iodine-125 ( 125 I) seeds strand has been applied to the treatment of cholangiocarcinoma and portal vein tumor thrombosis with promising results [19,20,21]. Studies have further con rmed that intraluminal brachytherapy using a single 125 I seeds strand is a viable and safe palliative treatment pressed by SEMs implantation, which can be used to treat cholangiocarcinoma and improve stent patency [22,23].…”

Section: Discussionmentioning

confidence: 99%

A Novel Brachytherapy Biliary Drainage Catheter Loaded With 125I Seeds in Patients With Malignant Obstructive Jaundice: Preliminary Results Versus Iodine-125 Seed Strands Placement

Jiao

Han

et al. 2020

Preprint

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Background The placement of 125I seeds was a safe method for treating cholangiocarcinoma .The purpose of this study was to compare a novel brachytherapy biliary drainage catheter (BBDC) with an Iodine-125 (125I) seed strand after self-expandable metallic stent(SEMs) implantation in terms of safety and efficacy, as treatments for patients with cholangiocarcinoma of malignant obstructive jaundice (MOJ). Methods From September 2016 to December 2018, We retrospectively enrolled patients with biliary stent implantation after receiving either BBDC loaded with 125I seeds (double-strands irradiation group) or an 125I seed strand treatment (single-strand irradiation group, control group). The outcomes were analyzed regarding the relief of obstructive jaundice, interventional-related complications, stent patency and survival time. ResultsThe success rate of interventional therapy in both groups was 100% and all patients with MOJ were alleviated . The overall complication rates of BBDC group and control group were 23.1% (9 / 39) and 26.5% (9/ 34), respectively (P > 0.05). The median and mean overall stent patency of the BBDC group and the control group were (207 days versus 180 days, 204.212 days versus 186.278 days, p = 0.043). The median and mean overall survivals in the BBDC group were higher than those in the control group (245 days versus 212 days, 244.883 days versus 221.844 days, p = 0.030). ConclusionsThis interim analysis showed that BBDC (double-stranded irradiation) can prolong the stent patency time compared with 125I seed strand treatment (single-stranded irradiation) and had the advantage of reducing jaundice, which seemed to extend survival period.

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Study of Percutaneous Stent Placement with Iodine-125 Seed Strand for Malignant Biliary Obstruction

Cited by 26 publications

References 19 publications

Biliary self-expandable metallic stent combined with Iodine-125 seeds strand in the treatment of hilar malignant biliary obstruction

Biliary self-expandable metallic stent combined with Iodine-125 seeds strand in the treatment of hilar malignant biliary obstruction

A novel combination of percutaneous stenting with iodine-125 seed implantation and chemotherapy for the treatment of pancreatic head cancer with obstructive jaundice

A Novel Brachytherapy Biliary Drainage Catheter Loaded With 125I Seeds in Patients With Malignant Obstructive Jaundice: Preliminary Results Versus Iodine-125 Seed Strands Placement

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