Radioactive Stent for Malignant Esophageal Obstruction: A Meta-Analysis of Randomized Controlled Trials

To compare the relative clinical efficacies of radioactive and normal stent insertion methods as a means of treating patients suffering from malignant esophageal obstruction (MEO). The Pubmed, Embase, and Cochrane Library databases were searched for relevant randomized controlled trials (RCTs) from the date of inception through to July 2020. RevMan v5.3 was used for all data analyses. This meta-analysis included six RCTs that included a total of 194 patients who had undergone radioactive stent insertion and 209 who had normal stent insertion. There were no significant differences in pooled improvement of dysphagia scores (P = .40), rates of stent restenosis (24.7% versus 28.7%, P = .35), stent migration (3.3% versus 4.4%, P = .61), severe chest pain (22.8% versus 20.3%, P = .61), hemorrhage (11.0% versus 9.8%, P = .80), or fistula formation (6.1% versus 4.2%, P = .55) between two groups. The pooled time to restenosis (P < .00001) and survival (P < .00001) were significant longer in the radioactive stent group. Significant heterogeneity was detected in the endpoint of improvement of dysphagia score (I² = 89%; P = .0002). Funnel plot analyses did not detect any evidence of publication bias pertaining to the selected study endpoints. Our meta-analysis demonstrated that radioactive stent insertion can prolong stent patency and survival for patients with MEO compared with normal stent insertion.