HDR-192Ir intraluminal brachytherapy in treatment of malignant obstructive jaundice.
OBJECTIVE
To determine the feasibility and safety of intraluminal brachytherapy in treatment of malignant obstructive jaundice (MOJ) and to evaluate the clinical effect of intraluminal brachytherapy on stent patency and patient survival.


METHODS
Thirty-four patients with MOJ were included in this study. Having biliary stent placed, all patients were classified into intraluminal brachytherapy group (group A, n = 14) and control group (group B, n = 20) according to their own choice. Intraluminal brachytherapy regimen included: HDR-192Ir was used in the therapy, fractional doses of 4-7 Gy were given every 3-6 d for 3-4 times, and standard points were established at 0.5-1.0 cm. Some patients of both groups received transcatheter arterial chemoembolization (TACE) after stent placement.


RESULTS
In group A, the success rate of intraluminal brachytherapy was 98.0%, RTOG grade 1 acute radiation morbidity occurred in 3 patients, RTOG/EORTC grade 1 late radiation morbidity occurred in 1 patient. Mean stent patency of group A (12.6 mo) was significantly longer than that of group B (8.3 mo) (P<0.05). There was no significant difference in the mean survival (9.4 mo vs 6.0 mo) between the two groups.


CONCLUSIONS
HDR-192Ir intraluminal brachytherapy is a safe palliative therapy in treating MOJ, and it may prolong stent patency and has the potentiality of extending survival of patients with MOJ.
Chen
Yi
Y
Department of Radiology, Affiliated Zhongshan Hospital, Medical Center of Fudan University, Shanghai 200032, China.
Wang
Xiao-Lin
XL
Yan
Zhi-Ping
ZP
Cheng
Jie-Min
JM
Wang
Jian-Hua
JH
Gong
Gao-Quan
GQ
Qian
Sheng
S
Luo
Jian-Jun
JJ
Liu
Qing-Xin
QX
D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications / Q000401:mortality / Q000532:radiotherapy*; D001653:Bile Ducts, Intrahepatic; D001918:Brachytherapy / Q000379:methods*; D018281:Cholangiocarcinoma / Q000150:complications / Q000401:mortality / Q000532:radiotherapy*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007496:Iridium Radioisotopes; D041781:Jaundice, Obstructive / Q000209:etiology / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D015607:Stents
D007496:Iridium Radioisotopes