Treatment of malignant biliary obstruction by combined percutaneous transhepatic biliary drainage with local tumor treatment.
OBJECTIVE
To evaluate the utility of local tumor therapy combined with percutaneous transhepatic biliary drainage (PTBD) for malignant obstructive biliary disease.


METHODS
A total of 233 patients with malignant biliary obstruction were treated in our hospital with PTBD by placement of metallic stents and/or plastic tubes. After PTBD, 49 patients accepted brachytherapy or extra-radiation therapy or arterial infusion chemotherapy. The patients were followed up with clinical and radiographic evaluation. The survival and stent patency rate were calculated by Kaplan-Meier survival analysis.


RESULTS
Twenty-two patients underwent chemotherapy (11 cases of hepatic carcinoma, 7 cases of pancreatic carcinoma, 4 cases of metastatic lymphadenopathy), and 14 patients received radiotherapy (10 cases of cholangiocarcinoma, 4 cases of pancreatic carcinoma), and 13 patients accepted brachytherapy (7 cases of cholangiocarcinoma, 3 cases of pancreatic carcinoma, 4 cases of metastatic lymphadenopathy). The survival rate of the local tumor treatment group at 1, 3, 6, and 12 months was 97.96%, 95.92%, 89.80%, and 32.59% respectively, longer than that of the non treatment group. The patency rate at 1, 3, 6, and 12 months was 97.96%, 93.86%, 80.93%, and 56.52% respectively. The difference of patency rate was not significant between treatment group and non treatment group.


CONCLUSIONS
Our results suggest that local tumor therapy could prolong the survival time of patients with malignant biliary obstruction, and may improve stent patency.
Qian
Xiao-Jun
XJ
Department of Interventional Radiology, Beijing Chaoyang Hospital, Capital University of Medical Sciences, 8 Baijiazhuang lu, Chaoyang District, Beijing 100020, China. qian_xj_70@yahoo.com.cn
Zhai
Ren-You
RY
Dai
Ding-Ke
DK
Yu
Ping
P
Gao
Li
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic; D001918:Brachytherapy; D016461:Chemoembolization, Therapeutic; D018281:Cholangiocarcinoma / Q000401:mortality / Q000628:therapy*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000628:therapy*; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000628:therapy*; D015996:Survival Rate