Korean Journal of Gastrointestinal Endoscopy  2000;20(6):449-455

The Efficacy of Intraluminal Radiotherapy after Metallie Stent Insertion in Malignant Biliary Tract Obstruction.

In Han KIM 1 ; Don Haeng LEE ; Jong Gil YOO ; Kye Sook KWON ; Hyeon Geun CHO ; Won CHOI ; Pum Soo KIM ; Hyung Gil KIM ; Yong Woon SHIN ; Young Soo KIM ; Sung Gwon KANG ; Woo Chul KIM

Affiliations

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Keywords

Malignant biliary tract obstruction; Metallic stent; Intraluminal radiotherapy; Stent patency; Survival time

Country

Republic of Korea

Language

Korean

Abstract

BACKGROUND/AIMS: Inoperable malignant biliary tract obstructions (MBTO) are best palliated by drainage procedures followed by radiation therapy. In order to administer high doses in a short time to the central part of the tumor, internal radiotherapy has been proposed for a palliative goa1. The aim of this study is to investigate the effect of intraluminal radiotherapy (ILRT) to the stent patency and patients survival time after expandable metallic stent insertion in MBTO. METHODS: Between August 1996 and July 1998, 28 patients (17 females, 11 males, average age 61.4 years) with inoperable MBTO were provided with percutaneous transhepatic biliary drainage (12 patients; bile duct cancer, 8 patients; pancreatic head cancer, 4 patients; gallbladder cancer; 4 patients; lymph node metastasis from stomach cancer). The 14 patients were treated by only metallic stent. The other 14 patients were treated by metallic stent insertion and followed by ILRT. The ILRT was done by iridium-192 (mean dosage 23.3 Gray, 5 fractions). RESULTS: There were no significant differences in the two groups regarding age, sex, type of disease, and location of the obstruction. The patients tolerated ILRT well. CONCLUSIONS: The ILRT after expandable metallic stent was safe and effective in stent patency and the patient's surviva1 time in inopcrable MBTO.