Intraluminal implantation of radioactive stents for treatment of primary carcinomas of the peripancreatic-head region: a pilot study.

摘要

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. DESIGN AND SETTING: 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. INTERVENTIONS: 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. MAIN OUTCOME MEASUREMENTS: 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.