Analysis of the therapeutic effect of 125I particle stent placement in unresectable extrahepatic cholangiocarcinoma

WANG Xuejun; ZHU Jun; QI Zhi; PAN Jie; HUANG Rui

doi:10.3969/j.issn.1674-4136.2024.03.009

Abstract：Objective To explore the therapeutic effect of 125I particle stent placement in unresectable extrahepatic cholangiocarcinoma.Methods Sixty-four patients with extrahepatic cholangiocarcinoma admitted to Yancheng Third People's Hospital from January 2015 to January 2023 were retrospectively analyzed.According to the treatment method,there were 34 cases in the observation group and 30 cases in the control group.The control group was treated with bare metal biliary stent,while the observation group was treated with 125I particle biliary stent implantation.The surgical time of both groups was recorded.After one month of treatment,the levels of bilirubin,carcinoembryonic antigen(CEA),carbohydrate antigen(CA)19-9,alkaline phosphatase,γ glutamyl transpeptidase,alanine aminotransferase,complications and adverse reactions were compared.Stent patency time and median overall survival(OS)were recorded during 12 months of follow-up.Results The surgical time of the observation group and the control group were(32.61±10.91)minutes and(21.09±8.37)minutes,respectively.The surgical time of the observation group was shorter than that of the control group,and the difference was statistically significant(P＜0.05).After treatment,the bilirubin levels in the observation group and the control group were(20.56±4.02)μmol/L and(27.85±4.16)μmol/L,respectively.Compared with the levels before treatment,the bilirubin levels in both groups decreased,and the observation group was lower than the control group(P＜0.05).After treatment,the CEA and CA19-9 levels in both groups decreased on average,and the observation group was lower than the control group(P＜0.05).After treatment,the alkaline phosphatase levels in both groupsγ-The levels of glutamyltransferase and alanine aminotransferase decreased,and the observation group was lower than the control group(P＜0.05).The incidence of adverse reactions in the observation group and the control group were 14.71％(5 cases/34 cases)and 13.33％(4 cases/30 cases),respectively,with no statistically significant difference(P＞0.05).The stent patency time of the observation group and the control group were(10.37±1.06)months and(6.74±0.81)months,respectively.The stent patency time of the observation group patients was longer than that of the control group,and the difference was statistically significant(P＜0.05).The median OS of the observation group was 12 months while the median OS of the control group was 9 months.The OS curve of the observation group was higher than that of the control group(P＜0.05).Conclusions 125I particle stent placement for the treatment of unresectable extrahepatic cholangiocarcinoma helps to improve biliary obstruction,prolong stent patency,inhibit tumor marker expression,and has good safety.