title: Effect of external beam radiotherapy on patency of uncovered metallic stents in patients with inoperable bile duct cancer.
abstract: BACKGROUND
  Although biliary decompression with metallic stenting is the preferred treatment for inoperable bile duct cancer (BDC), maintenance of patency is still unsatisfactory. We tried to assess the effectiveness and safety of external beam radiotherapy (EBRT) for prolonging stent patency in patients having uncovered metallic stents.
  
  
  METHODS
  We retrospectively reviewed 50 patients who received endoscopic stenting, of whom 18 received EBRT (RT group) and 32 did not (non-RT group).
  
  
  RESULTS
  No difference was found in baseline characteristics between the two groups. Although stent patency was longer in the RT group than that in the non-RT group (140.7+/-51.3 vs 136.4+/-34.9 days, P=0.94), the difference was not statistically significant. There were a lower rate of stent occlusion (27.8% vs 50.0% of patients, P=0.12) and a longer overall survival (420.1+/-73.2 vs 269.1+/-41.7 days, P=0.11) in the RT group than in the non-RT group, and the difference again was not statistically significant. The development of adverse reactions did not differ (55.6% vs 53.1% of patients, P=0.91). There was no serious adverse reaction in both groups (P=0.99).
  
  
  CONCLUSIONS
  EBRT did not significantly improve stent patency in patients with inoperable BDC having uncovered metallic stents. However, EBRT was safe. Future trials with refined protocols for better efficacy are expected.
authors.affiliation: Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul 110-744, Korea. gidoctor@snu.ac.kr.
authors.forename: Jun Kyu
authors.initials: JK
authors.lastname: Lee
authors.forename: Won Kwon
authors.initials: WK
authors.lastname: Kwack
authors.forename: Sang Hyub
authors.initials: SH
authors.lastname: Lee
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Jung
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Kwon
authors.forename: In Woong
authors.initials: IW
authors.lastname: Han
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications* / Q000175:diagnosis; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000295:instrumentation*; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology / Q000532:radiotherapy / Q000628:therapy*; D003664:Decompression / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D010166:Palliative Care; D011474:Prosthesis Design; D011475:Prosthesis Failure; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals