title: Radiotherapy prolongs biliary metal stent patency in malignant pancreatobiliary obstructions.
abstract: OBJECTIVE
  Biliary stenting is the most effective decompressive method for treating malignant biliary obstructive jaundice. Although the main cause of stent occlusion is tumor growth, few studies have investigated whether stent patency is affected by the combination of cancer-treatment modalities. The aim of this study was to evaluate the effects of local radiotherapy on metal-stent patency in patients with malignant biliary obstruction.
  
  
  METHODS
  Patients who underwent self-expandable biliary metallic stenting for malignant biliary obstruction from 1999 to 2007 were included. Forty patients received chemotherapy and radiation therapy (radiation group, RG), and 31 patients received only chemotherapy (nonradiation group, NRG).
  
  
  RESULTS
  The cumulative median stent patency was significantly longer in the RG than in the NRG (17.7 months; 95% confidence interval [CI], 1.8 to 33.6 months vs 8.7 months; 95% CI, 4.9 to 12.5 months; p=0.025). Stent occlusion caused by tumor growth or stent migration occurred in two (5%) and three (7.5%) cases in the RG and in six (19.3%) and two (6.5%) cases in the NRG, respectively.
  
  
  CONCLUSIONS
  The patency of biliary metal stents in pancreatobiliary cancer patients who receive chemoradiation therapy is significantly longer than that in patients who do not receive radiotherapy, which suggests that local cancer control significantly affects stent patency.
authors.affiliation: Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, Seoul, Korea. ; Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Semi
authors.initials: S
authors.lastname: Park
authors.forename: Jeong Youp
authors.initials: JY
authors.lastname: Park
authors.forename: Seungmin
authors.initials: S
authors.lastname: Bang
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Jae Bock
authors.initials: JB
authors.lastname: Chung
authors.forename: Si Young
authors.initials: SY
authors.lastname: Song
keywords: Biliary metal stent; Malignant biliary obstruction; Radiotherapy; Stent patency
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