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Published on: April 17, 2020
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I-125 seed-loaded versus normal stent insertion for obstructive esophageal cancer: a meta-analysis
Chun-Lei Zhao1, Bing Gu2, Xiao-Bing Huo2
1Interventional Operating Theater, Binzhou People's Hospital, Binzhou, China.
Summary
I-125 seed-loaded stents (ISS) offer improved stent patency and survival for malignant esophageal obstruction compared to normal stents (NS). This meta-analysis found ISS provides longer-lasting relief and better survival outcomes for patients with incurable obstructive esophageal cancer.
Area of Science:
- Oncology
- Gastroenterology
- Interventional Radiology
Background:
- Malignant esophageal obstruction (MEO) is a severe complication, often incurable at diagnosis.
- Obstructive esophageal cancer (OEC) frequently necessitates palliative interventions.
- Stent insertion is a primary treatment for OEC to restore esophageal patency.
Purpose of the Study:
- To compare the clinical effectiveness of I-125 seed-loaded stents (ISS) against normal stents (NS) for OEC.
- To evaluate patient outcomes and complication rates associated with each stent type.
Main Methods:
- A systematic meta-analysis of studies published up to November 2020.
- Databases searched include PubMed, Embase, and Cochrane Library.
- RevMan v5.3 software was utilized for data analysis.
Main Results:
- No significant differences were observed in dysphagia scores, restenosis, migration, chest pain, hemorrhage, pneumonia, or fistula rates between ISS and NS.
- However, ISS demonstrated significantly longer time-to-restenosis and improved survival rates compared to NS (p=0.04 and p<0.0001, respectively).
- Significant heterogeneity was noted for dysphagia scores and survival, with no publication bias detected.
Conclusions:
- I-125 seed-loaded stent insertion is a superior palliative option for OEC.
- ISS provides enhanced stent patency and prolonged survival compared to conventional NS.
- Further research may explore optimal application and management of ISS in OEC patients.
