Technique for the administration of high-dose-rate brachytherapy to the bile duct using a nasobiliary catheter

Deufel, Christopher L.; Furutani, Keith M.; Dahl, Robert A.; Grams, Michael P.; McLemore, Luke B.; Hallemeier, Christopher L.; Neben-Wittich, M.A.; Martenson, James A.; Haddock, Michael G.

doi:10.1016/j.brachy.2018.03.006

Cited by 10 publications

(6 citation statements)

References 16 publications

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“…Considering the poor prognosis and the lack of curative treatment for advanced GBC, new endoscopic locoregional treatments have been described to prolong the patient’s survival and improve the quality of life. Endoscopic radiofrequency ablation (RFA), intraluminal brachytherapy (IBT), and endoscopic photodynamic therapy (PDT) have been studied for the management of biliary malignancies [ 76 , 77 , 78 , 79 ].…”

Section: Locoregional Therapiesmentioning

confidence: 99%

“…IBT provides the local delivery of high-dose radiation, enhancing the anti-neoplastic effect inside the tumor tissue and reducing the exposure to radiation of adjacent structures. The endoscopic approach involves the placement of a naso-biliary tube (NBT) in the biliary tree, and the insertion of a BT catheter inside the NBT for the delivery of high-dose radiation or the placement of a 124 I seeds stent through the biliary stricture [ 78 , 83 ]. Xu et al, in a metanalysis of 12 studies involving 641 patients with malignant biliary obstruction (among them 45 were diagnosed with GBC), reported that patients treated with IBT were associated with lower incidence of stent occlusion and longer overall survival when compared with patients treated with biliary stent alone [ 84 ].…”

Section: Locoregional Therapiesmentioning

confidence: 99%

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Palliation in Gallbladder Cancer: The Role of Gastrointestinal Endoscopy

Schepis

Boškoski

Tringali

et al. 2022

Cancers

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Gallbladder cancer is a rare malignancy burdened by poor prognosis with an estimated 5-year survival of 5% to 13% due to late presentation, early infiltration of surrounding tissues, and lack of successful treatments. The only curative approach is surgery; however, more than 50% of cases are unresectable at the time of diagnosis. Endoscopy represents, together with surgery and chemotherapy, an available palliative option in advanced gallbladder cancers not eligible for curative treatments. Cholangitis, jaundice, gastric outlet obstruction, and pain are common complications of advanced gallbladder cancer that may need endoscopic management in order to improve the overall survival and the patients’ quality of life. Endoscopic biliary drainage is frequently performed to manage cholangitis and jaundice. ERCP is generally the preferred technique allowing the placement of a plastic stent or a self-expandable metal stent depending on the singular clinical case. EUS-guided biliary drainage is an available alternative for patients not amenable to ERCP drainage (e.g., altered anatomy). Gastric outlet obstruction is another rare complication of gallbladder malignancy growing in contact with the duodenal wall and causing its compression. Endoscopy is a less invasive alternative to surgery, offering different options such as an intraluminal self-expandable metal stent or EUS-guided gastroenteroanastomosis. Abdominal pain associated with cancer progression is generally managed with medical treatments; however, for incoercible pain, EUS-guided celiac plexus neurolysis has been described as an effective and safe treatment. Locoregional treatments, such as radiofrequency ablation (RFA), photodynamic therapy (PDT), and intraluminal brachytherapy (IBT), have been described in the control of disease progression; however, their role in daily clinical practice has not been established yet. The aim of this study is to perform a review of the literature in order to assess the role of endoscopy and the available techniques in the palliative therapy of advanced gallbladder malignancy.

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Section: Locoregional Therapiesmentioning

confidence: 99%

Section: Locoregional Therapiesmentioning

confidence: 99%

Palliation in Gallbladder Cancer: The Role of Gastrointestinal Endoscopy

Schepis

Boškoski

Tringali

et al. 2022

Cancers

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show abstract

“…HDR brachytherapy allows safe delivery of higher doses of radiation targeted at the tumor site and is an integral part of the regimen to maximize tumor response and local control. 3 ERCP is used to place nasobiliary catheters (NBCs) to facilitate HDR biliary brachytherapy. Previously published experiences from our institution have described high technical and clinical feasibility of endoscopically inserted NBC for HDR brachytherapy.…”

Section: Background and Aimsmentioning

confidence: 99%

“…Previously published experiences from our institution have described high technical and clinical feasibility of endoscopically inserted NBC for HDR brachytherapy. 3,4 This video (Video 1, available online at www.giejournal.org) reviews the technical aspects associated with NBC insertion and describes potential challenges and how they are managed.…”

Section: Background and Aimsmentioning

confidence: 99%

“…Between 2007 and 2017, 122 patients underwent endoscopic NBC insertion, with a total of 3 procedure failures (2 cases of catheter migration between NBC placement and time of brachytherapy and 1 case of failure of the HDR afterloader to advance the radiation source to the desired treatment site). 3 To prevent loss of guidewire access, once the desired biliary segment has been accessed with the angled guidewire, it may be exchanged for a stiffer, PTFEcovered 0.035-inch guidewire (Jagwire, Boston Scientific) to increase stability and thus minimize wire slippage and catheter displacement during NBC deployment.…”

Section: Endoscopic Techniquementioning

confidence: 99%

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