eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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abstract:
Review paper

I-125 seed-loaded versus normal stent insertion for obstructive esophageal cancer: a meta-analysis

Chun-Lei Zhao
1
,
Bing Gu
2
,
Xiao-Bing Huo
2
,
Feng-Fei Xia
3

1.
Interventional Operating Theater, Binzhou People’s Hospital, Binzhou, China
2.
Department of Radiology, Binzhou People’s Hospital, Binzhou, China
3.
Department of Interventional Vascular Surgery, Binzhou People’s Hospital, Binzhou, China
Videosurgery Miniinv
Online publish date: 2021/03/08
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Introduction
Malignant esophageal obstruction is usually caused by esophageal and other chest cancers. More than 80% of cases of obstructive esophageal cancer (OEC) have lost the chance of curative resection. Stent insertion is a first-line palliative approach used to treat incurable OEC. Aim: To gauge the relative clinical efficacy of I-125 seed-loaded stent (ISS) versus normal stent (NS) insertion as a treatment for OEC.

Material and methods
Querying of the PubMed, Embase, and Cochrane Library databases was conducted to find all relevant studies published up to November 2020. The meta-analysis was undertaken using RevMan v5.3.

Results
We identified 158 studies initially, eight (4 randomized controlled trials and 4 retrospective studies) of which were used in this meta-analysis. We found that the two groups exhibited the comparable pooled dysphagia scores (MD = 0.02; p = 0.80), stent restenosis rates (OR = 0.97; p = 0.89), stent migration rates (OR = 0.81; p = 0.63), severe chest pain rates (OR = 1.05; p = 0.81), hemorrhage rates (OR = 1.53; p = 0.16), aspiration pneumonia rates (OR = 0.72; p = 0.38), and fistula formation rates (OR = 1.47; p = 0.44). The pooled time-to-restenosis and survival were both significantly longer in the ISS group (p = 0.04 and < 0.0001, respectively). Significant heterogeneity was detected in the endpoints of dysphagia scores and survival (I2 = 73% and 86%, respectively). Funnel plot analysis indicated an absence of publication bias related to the selected study endpoints.

Conclusions
For patients with OEC, our meta-analysis indicated that ISS insertion could provide longer stent patency and survival than NS insertion.

keywords:

I-125, seed, stent, esophageal cancer

  
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