Irradiation stents: A clever, and maybe costly, fusion

摘要

Oesophageal cancer is a leading cause of cancer death worldwide. Most cases of oesophageal cancer (83%) and deaths due to this disease (86%) occur in low-income and middle-income countries. Despite many advances, cure remains unachievable for most patients with oesophageal cancer, and the primary treatment goals become palliative and supportive. The ideal palliative therapy would provide rapid and sustained relief of dysphagia (the primary symptom of advanced oesophageal cancer) with one intervention, result in few complications, be widely available at low cost, have minimum need for hospital admission or re-intervention, and extend survival. In The Lancet Oncology, Hai-Dong Zhu and colleagues2 present their second randomised, controlled clinical trial comparing placement of conventional endoluminal stents with novel stents that incorporate 125I seeds. These investigators are attempting to combine the advantages of stents and brachytherapy into a single-treatment modality. In their previous pilot study,3 the investigators reported a remarkable difference in mean survival (8.3 months for the 125I stents and 35 months for the conventional stents).