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Radioactive Seed Strand Efficacy in Superior Vena Cava Stenting Due to Non-small-cell Lung Cancer Obstruction
Fu-Kang Yuan1, Yu-Fei Fu2, Yi-Bing Shi2
1Department of Vascular Surgery, 159434Xuzhou Central Hospital, Xuzhou, China.
Purpose:
This study aims to determine the clinical effectiveness of a stent with radioactive seed strand (RSS) inserted in patients with superior vena cava (SVC) obstruction (SVCO) secondary to non-small-cell lung cancer (NSCLC).
Methods:
Between January 2013 and December 2019, 63 patients with SVCO related to NSCLC received stent implantation with (n = 30) or without (n = 33) RSS insertion at our center. The clinical efficacy, stent patency duration, and overall survival (OS) were compared between these two groups.
Results:
Both groups achieved 100% clinical and technical success rates. There were no obstacles associated with the procedure performed for the patients. Two patients in the RSS group and 7 patients in the stent-alone group experienced stent re-stenosis. The rate of re-stenosis between the two groups was not significantly different (P = .099). Patients in the RSS group had significantly longer median patency than those in the stent-alone group (381 vs 309 days, P = .045). All patients died because of the development of tumors during the follow-up. Patients in the RSS group had a significantly longer median OS than those in the stent-alone group (229 vs 178 days, P = .026). During the follow-up, no patient in the RSS group suffered RSS migration or brachytherapy-related complications.
Conclusion:
For patients with SVCO secondary to NSCLC, a stent with RSS insertion is efficacious and safe, and it may improve stent patency and OS.
Insights
Radioactive seed strand (RSS) insertion with stents improved stent patency and overall survival in patients with superior vena cava obstruction (SVCO) caused by non-small-cell lung cancer (NSCLC). The procedure was safe and effective.
Area of Science:
- Interventional Radiology
- Oncology
- Cardiovascular Medicine
Background:
- Superior vena cava obstruction (SVCO) is a serious complication of non-small-cell lung cancer (NSCLC).
- Stent implantation is a common treatment for SVCO, but re-stenosis can occur.
Purpose of the Study:
- To evaluate the clinical effectiveness of stent implantation with radioactive seed strand (RSS) insertion for SVCO secondary to NSCLC.
- To compare stent patency and overall survival (OS) between patients treated with stents with RSS and stents alone.
Main Methods:
- A retrospective study included 63 patients with NSCLC-related SVCO.
- Patients received stent implantation with (n=30) or without (n=33) RSS insertion.
- Clinical efficacy, stent patency, and OS were compared between groups.
Main Results:
- Both groups had 100% clinical and technical success rates.
- RSS group showed significantly longer median stent patency (381 vs 309 days) and OS (229 vs 178 days).
- No significant difference in re-stenosis rates; no RSS migration or brachytherapy complications observed.
Conclusions:
- Stent with RSS insertion is an effective and safe treatment for SVCO in NSCLC patients.
- This approach may improve stent patency and overall survival.
- RSS insertion offers a promising adjunctive therapy for managing malignant SVCO.
