Malignant obstructive jaundice Treated by Intraluminal Brachytherapy Combined With stent placement or Stent Implantation Alone

Abstract

To compare the safety and efficacy of intraluminal implantation of Iodine-125 (125I) seeds strand combined with stent versus stent placement alone for treatment of patients with malignant obstructive jaundice (MOJ). From January 2009 to December 2013, the data of 319 consecutive patients with MOJ treated with stent placement were retrospectively analyzed. 125I seeds strand was implanted in the obstructed bile duct of 107 patients (group A). No brachytherapy was performed in the remaining 212 patients (group B). Clinical outcomes, treatment related complications,stent patency period and overall survival were compared between two groups. All 125I seeds strands and stents were successfully implanted without serious procedure-related adverse events. During a mean of 220 days follow-up,mean survival time in group A and B was 423.2 days (95% CI 344.5–501.8 days) and 344.4 days (95% CI 289.1–399.8 days), respectively (p=0.033). Mean stent patency period in group A was 353.7 days (95% CI 293.0 -414.3 days) compared to 280.9 days (95% CI 243.7–318.2 days) in group B (p=0.031). Compared to stent placement alone, the combination of 125I seeds strand and stent implantation appears to be more effective in treatment of patients with malignant obstructive jaundice.