title: [Dual interventional therapy for malignant gastroduodenal obstruction].
abstract: OBJECTIVE
  The patients with malignant gastroduodenal obstruction usually have unresectable primary lesion and distant metastasis. Intra-luminal metallic stent implantation followed by intra-arterial chemotherapy via the tumor feeding arteries, so-called "dual interventional therapy", could temporarily relieve obstructive symptoms. This study was to evaluate the clinical safety and efficacy of dual interventional therapy on advanced malignant gastroduodenal obstruction.
  
  
  METHODS
  A total of 65 patients with malignant gastroduodenal obstruction underwent dual interventional therapy. Of the 65 patients, 33 had pyloric antrum obstruction, 22 had duodenal obstruction, and 10 had gastroduodenal obstruction with gastrojejunostomal obstruction; 9 had liver metastasis. The patients' survival was analyzed by log-rank test.
  
  
  RESULTS
  Stents were successfully implanted into all enrolled patients. No severe adverse events were observed in these patients. The cumulative survival rates at 3, 6, 9, and 12 months after dual interventional therapy were 90%, 66%, 49%, and 28%, respectively. The median survival time was 11.9 months.
  
  
  CONCLUSIONS
  The dual interventional therapy, with metallic stent implantation to relieve malignant obstruction and high-selective intra-arterial chemotherapy to control tumor growth, is a safe, feasible and effective treatment for malignant gastroduodenal obstruction.
authors.affiliation: Department of Radiology, Luwan Branch of Ruijin Hospital, Shanghai Jiaotong University, Shanghai, 200020, P. R. China. wzm0722@yahoo.com.cn
authors.forename: Zhong-Min
authors.initials: ZM
authors.lastname: Wang
authors.forename: Ke-Min
authors.initials: KM
authors.lastname: Chen
authors.forename: Ju
authors.initials: J
authors.lastname: Gong
authors.forename: Chao-Xian
authors.initials: CX
authors.lastname: Wu
authors.forename: Yun-Feng
authors.initials: YF
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D000970:Antineoplastic Agents / Q000627:therapeutic use; D004380:Duodenal Obstruction / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D005260:Female; D017219:Gastric Outlet Obstruction / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications; D015996:Survival Rate
chemical_list: D000497:Alloys; D000970:Antineoplastic Agents