Endoscopic intraluminal brachytherapy and metal stent in malignant XXXX : a pilot study.

@entity1 @entity253 @entity1168 @entity255
BACKGROUND/AIMS: Malignant @entity253 carries a poor prognosis, as the disease is often unresectable at the time of diagnosis. Various palliative measures as surgical/radiological/ endoscopic drainage with or without radiotherapy/chemotherapy have been tried with dismal outcome. We prospectively studied the effect of unilateral metal stent with intraluminal @entity1168 ( @entity1168 ) brachytherapy in @entity1 with type II malignant @entity253 . METHODS: Eight @entity1 with type II malignant @entity253 were treated with contrast-free unilateral metal stenting followed by endoscopic intraluminal brachytherapy (ILBT). A retrospectively analyzed group of 10 @entity1 treated only with contrast-free unilateral metal stenting served as historical controls. RESULTS: A successful drainage was achieved in all, @entity255 occurred in none and no @entity1 died within 30 days in both groups. The mean (+/-SD) patency of metal stent was 305 (+/-183.96) days and 143.9(+/-115.11) days in @entity1 with and without intraluminal brachytherapy, respectively (P=0.03). Mean (+/-SD) survival of these @entity1 was 310 (+/-192.68) days and 154.9 (+/-122.51) days in @entity1 with and without intraluminal brachytherapy, respectively (P=0.05). Kaplan-Meier analysis showed estimated median survival of 225 (95% CI; 169.5, 280.4) days in brachytherapy and 100 (95%CI; 94.1, 105.8) days in control group (P=0.025). No major complications related to metal stent or ILBT were observed. CONCLUSIONS: Contrast-free unilateral metal stenting with @entity1168 ILBT in type II malignant @entity253 is a safe and effective method of palliation and appears to prolong @entity1 survival as well as patency of stent in these @entity1 , however, a larger, randomized trial is required to validate the same.
