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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 2/2018

01-02-2018 | Review

A Systematic Review and Meta-analysis of Intraluminal Brachytherapy Versus Stent Alone in the Treatment of Malignant Obstructive Jaundice

Authors: Xinjian Xu, Jingjing Li, Juan Wu, Rui Zhu, Wenbin Ji

Published in: CardioVascular and Interventional Radiology | Issue 2/2018

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Abstract

Objectives

To evaluate therapeutic outcomes of intraluminal brachytherapy (ILBT) for malignant obstructive jaundice (MOJ) against stent alone.

Methods

The PubMed, EMBASE, Cochrane Library, CNKI, Wan Fang, VIP and ClinicalTrials.gov databases were searched for all relevant comparative studies from the earliest available date up to 1 May 2017. Subgroup analyses were performed according to the type of study design and type of stent.

Results

Twelve studies that compared ILBT versus stent alone were eligible. A total of 641 participants with MOJ were included in our meta-analysis. A total of 340 participants were treated with intraluminal brachytherapy (ILBT); the other 301 participants were treated with biliary stent alone (stent group). ILBT was associated with lower risk of stent occlusion (OR 0.19; 95% CI 0.13–0.28; P < 0.00001) and better mean survival (MD = 3.15; 95% CI 2.64–3.66; P < 0.00001) compared with stent alone. However, the two groups were similar in number of complications (OR 0.84; 95% CI 0.45–1.56; P = 0.578), post-treatment reduced level of total bilirubin (TBIL) (MD = 22.71; 95% CI − 7.24–52.65; P = 0.14), post-treatment reduced level of direct bilirubin (DBIL) (MD = − 3.67; 95% CI − 14.09–6.75; P = 0.49), post-treatment reduced level of alanine aminotransferase (ALT) (MD = 21.09; 95% CI − 5.09–47.28; P = 0.11) and post-treatment reduced level of aspartate aminotransferase (AST) (MD = 20.86; 95% CI − 45.86–87.58; P = 0.54).

Conclusions

ILBT was significantly superior to stent alone in terms of stent occlusion and mean survival. Meanwhile, ILBT had comparable outcomes to stent alone in terms of complications and post-treatment reduced levels of TBIL, DBIL, ALT and AST. Therefore, ILBT may be considered a preferable technique for MOJ.
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Metadata
Title
A Systematic Review and Meta-analysis of Intraluminal Brachytherapy Versus Stent Alone in the Treatment of Malignant Obstructive Jaundice
Authors
Xinjian Xu
Jingjing Li
Juan Wu
Rui Zhu
Wenbin Ji
Publication date
01-02-2018
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 2/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-017-1827-6

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