Intraluminal implantation of radioactive stents for treatment of primary carcinomas of the peripancreatic-head region: a pilot study.
BACKGROUND
Patients diagnosed with bile-duct, pancreatic-head, and ampullary carcinomas have a poor prognosis.


OBJECTIVE
This study evaluated the potential curative efficacy and safety of intraluminal brachytherapy by using radioactive stents for palliative treatment of these patients.


METHODS
Patients with inoperable extrahepatic bile-duct (n = 2), pancreatic-head (n = 6), or ampullary (n = 3) carcinomas were treated by intraluminal implantation of radioactive stents designed according to a computerized treatment-planning system.


METHODS
Both radioactive stents and commonly used self-expanding metallic or plastic stents were placed in the common bile duct (CBD) of the patients. For pancreatic carcinoma, the combination of radioactive CBD and pancreatic duct (PD) stents or only a radioactive PD stent was chosen according to the tumor position.


METHODS
Survival, tumor status, and complications were assessed during the follow-up period.


RESULTS
A total of 16 radioactive stents were successively placed in all 11 patients. There were no life-threatening complications. The median survival was 150 days. After 2 months of the placement of radioactive stents, 8 patients (72.7%) had stable disease, whereas 3 patients (27.3%) showed progressive disease.


CONCLUSIONS
The combination of radioactive stents and metallic and/or plastic stents was technically feasible and tolerable in patients with advanced tumors around the pancreatic-head area.
Liu
Yan
Y
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Lu
Zheng
Z
Zou
Duo-wu
DW
Jin
Zhen-dong
ZD
Liu
Feng
F
Li
Shu-de
SD
Zhan
Xian-bao
XB
Zhang
Wen-jun
WJ
Wu
Ren-pei
RP
Yao
Yin-zhen
YZ
Yang
Li
L
Li
Zhaoshen
Z
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater; D001918:Brachytherapy / Q000295:instrumentation*; D003138:Common Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D018450:Disease Progression; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010183:Pancreatic Ducts; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D010865:Pilot Projects; D011874:Radiometry; D011880:Radiotherapy Planning, Computer-Assisted; D015607:Stents; D016019:Survival Analysis; D013813:Therapy, Computer-Assisted; D016896:Treatment Outcome
D007457:Iodine Radioisotopes