A Novel Tracheobronchial Stent Loaded with 125I Seeds in Patients with Malignant Airway Obstruction Compared to a Conventional Stent: A Prospective Randomized Controlled Study

EBioMedicine. 2018 Jul:33:269-275. doi: 10.1016/j.ebiom.2018.06.006. Epub 2018 Jun 14.

Abstract

Background: To evaluate the safety and efficacy of a novel radioactive bare metal stent (RBMS) compared with a conventional bare metal stent (CBMS) in patients with inoperable malignant airway obstruction.

Methods: This prospective study was approved by the Institutional Ethics Committee, and informed consent was obtained from each participant. Patients with malignant airway obstruction who had dyspnea were randomly assigned to receive RBMS or CBMS placement. The primary endpoint was stenosis grade, while the secondary endpoints were technical success, overall survival, and complications. A p value of <0·05 was considered statistically significant.

Results: Between September 2013 and July 2015, 66 patients with inoperable malignant airway obstruction received stent placement fluoroscopically (33 in either group). The median follow-up time was 154 days (range, 15-335 days). The baseline stenosis was immediately relieved in both groups after stent placement, and the stenosis grades in the RBMS group were significantly lower than that in the CBMS group since the second month (p < 0·05). The technical success rates of stent placement were 100% in both groups. The median survival in the RBMS group was significantly longer than that in the CBMS group (170 days vs. 123 days, p < 0·05). There was no significant difference in the incidence of complications between the two groups (p < 0·05).

Conclusions: The placement of RBMS in patients with inoperable malignant airway obstruction is feasible and safe, and it significantly reduces restenosis and improves overall survival compared with the placement of CBMS.

Keywords: Intraluminal brachytherapy; Malignant airway obstruction; Restenosis; Stent.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Airway Obstruction / radiotherapy*
  • Combined Modality Therapy
  • Drug-Eluting Stents / adverse effects
  • Female
  • Humans
  • Iodine Radioisotopes / administration & dosage*
  • Male
  • Middle Aged
  • Prospective Studies
  • Survival Analysis
  • Treatment Outcome

Substances

  • Iodine Radioisotopes
  • Iodine-125