Endovascular Treatment of Cancer-Associated Venous Obstruction: Comparison of Efficacy Between Stent Alone and Stent Combined With Linear Radioactive Seeds Strand
Autor: | Jinhua Song, Jianping Gu, Guoping Chen, Bei Wu, Xu He, Guowen Yin, Boxiang Zhao |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Prosthesis Design 030218 nuclear medicine & medical imaging Iodine Radioisotopes 03 medical and health sciences 0302 clinical medicine Neoplasms medicine Humans Vascular Diseases Endovascular treatment Vein Vascular Patency Aged Retrospective Studies Aged 80 and over business.industry Endovascular Procedures Stent Cancer General Medicine Middle Aged Neoplastic Cells Circulating medicine.disease Venous Obstruction Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Quality of Life Female Stents Surgery Radiology Radiopharmaceuticals Cardiology and Cardiovascular Medicine business |
Zdroj: | Vascular and Endovascular Surgery. 54:565-572 |
ISSN: | 1938-9116 1538-5744 |
Popis: | Objectives: To investigate the safety and efficacy of a stent combined with a linear strand of 125I seeds to treat malignant cancer–associated venous obstruction. Methods: We retrospectively analyzed the data of 57 patients with malignant cancer–associated venous obstruction. Nineteen patients underwent the placement of a stent combined with a linear strand of 125I seeds (group A), and 38 patients underwent the placement of a bare stent (group B). The following parameters were compared between the 2 groups of patients: symptom relief rate, duration of venous patency, survival time, quality of life, and adverse events. Results: A total of 34 stents and 527 seeds were implanted in group A, while a total of 57 stents were implanted in group B. The surgery success rate was 96.5%, and no serious complication related to the surgery was reported. Symptoms of venous obstruction improved significantly after surgery. The score of group A decreased from 14.74 ± 0.562 points before surgery to 2.79 ± 1.357 points after surgery( P < .001), and the score of group B decreased from 13.79 ± 1.398 points before surgery to 5.55 ± 3.674 points after surgery ( P < .001). The patency rate of group A was significantly higher than that of group B at 1 to 6 months after surgery (100%, 84.2%, 68.4%, 63.2%, 36.8%, 21.1% vs 68.4%, 23.7%, 18.4%, 7.9%, 5.3%, 2.6%, respectively; P < .05). Before treatment, there was no statistically significant difference in the Karnofsky Performance Status (KPS) score between the groups ( P = .791). After 1 to 6 months of treatment, the KPS score was significantly higher in group A than in group B ( P = .013). The median patency duration in groups A and B was 125 days (95% CI: 80.018-169.982) and 35 days (95% CI: 20.501-49.499), respectively ( P < .001). The median survival time of group A was 155 days (95% CI: 110.406-199.594), and that of group B was 98 days (95% CI: 55.712-140.288; P = .325). Multivariate analysis showed that the implantation of a stent combined with a linear strand of 125I seeds and the KPS score (≥80 points) were independent factors of long-term patency after stent placement. Conclusions: The placement of a stent combined with a linear strand of 125I seeds is a safe and effective treatment for venous obstruction caused by malignant tumors. This treatment provides prolonged patency compared with the placement of bare stent, and while it does not significantly improve the survival time of patients, it can improve their quality of life. |
Databáze: | OpenAIRE |
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