Stent placement with iodine-125 seeds strand effectively extends the duration of stent patency and survival in patients with unresectable malignant obstructive jaundice
Stent placement with iodine-125 seeds strand effectively extends the duration of stent patency and survival in patients with unresectable malignant obstructive jaundice
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DOI：
10.1080/00365521.2019.1707275
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发表时间：
2020-01-04
影响因子：
1.9
通讯作者：
Li, Zheng-ran
中科院分区：
文献类型：
--
作者：
Pan, Tao;Li, Ming-an;Li, Zheng-ran
背景资料：本研究旨在比较支架置入术联合或不联合碘-（125）（I-125）粒子股线治疗不可切除的恶性阻塞性黄疸（MOJ）患者的治疗结局和安全性。研究方法：回顾性纳入我院收治的84例无法切除的MOJ患者，分为支架组（n = 54）行胆道支架置入术和支架+粒子组（n = 30）行I-125粒子束支架置入术。比较两组的治疗效果、术后并发症、患者生存时间和支架通畅率。进行Kaplan-Meier生存分析，比较两组患者的生存期和支架通畅率。进行Cox回归分析以研究无病生存期和总生存期的预测因素。结果如下：支架+放射性粒子组的通畅持续时间（231.57 +/- 256.54 vs. 110.37 +/- 120.52）和总生存期（310.57 +/- 330.54 vs. 173.15 +/- 219.40）显著长于支架组（均p <0.05）。此外，Kaplan-Meier生存分析证实，支架+放射性粒子组的通畅持续时间（对数秩检验，p = 0.001）和总生存率（对数秩检验，p = 0.020）均高于支架组。此外，Cox回归分析表明，治疗方法是与无病生存期（HR：0.36，95% CI：0.19-0.70; p = 0.003）和总生存期（HR：1.01，95% CI：1.00-1.01; p <0.001）相关的独立因素。结论：I-125粒子束支架置入术可显著提高MOJ患者的一期通畅率和总生存时间。
Background: This study aimed to compare the treatment outcomes and safety between stent placement with or without Iodine-(125) (I-125) seeds strand for patients with unresectable malignant obstructive jaundice (MOJ). Methods: A total of 84 patients with unresectable MOJ treated in our hospital were retrospectively included and divided into the stent group (n = 54) undergoing biliary stent placement and the stent + seeds group (n = 30) receiving stent placement with I-125 seeds strand. The therapeutic outcome, postoperative complications, duration of patient survival and stent patency were compared between groups. Kaplan-Meier survival analysis was performed to compare the duration of patient survival and stent patency between groups. Cox-regression analysis was performed to investigate predictive factors for disease-free survival and overall survival. Results: The stent + seeds group had significantly longer duration of patency (231.57 +/- 256.54 vs. 110.37 +/- 120.52) and overall survival (310.57 +/- 330.54 vs. 173.15 +/- 219.40) than the stent group (both p < .05). In addition, Kaplan-Meier survival analysis confirmed that the stent + seeds group had longer duration of patency (log-rank test, p = .001) and higher overall survival rate (log-rank test, p = .020) than the stent group. Furthermore, Cox-regression analysis demonstrated that treatment methods was an independent factor associated with disease-free survival (HR: 0.36, 95% CI: 0.19-0.70; p = .003) and overall survival (HR: 1.01, 95% CI: 1.00-1.01; p < .001). Conclusion: The stent placement with I-125 seeds strand can significantly improve the primary patency rate and overall survival time in MOJ patients.