Clinical effect and safety of 125I particle stent on treatment of postoperative esophageal stricture for patients with advanced esophageal cancer

Objective To investigate clinical effect and safety of the 125I particle stent for treatment of postoperative esophageal stricture on patients with advanced esophageal cancer.Methods Sixty patients with postoperative esophageal stricture after esophageal cancer operation were randomly assigned to receive treatment with a conventional self-expanding stent (control group) or a stent loaded with 125I seeds (irradiation group).After stent implantation,the outcomes were compared in terms of the success rate of stent implantation,relief of dysphagia,survival time,and complications related to the procedure.Dysphagia was assigned a grade 0-4.The t test and the x2 test were used to make statistical analysis.Results The success rate of stents placement of two groups were 100％ (30/30).The results of preoperative dysphagia score showed that the patients of control group with 0,1,2,3,4 degree were 0,2,3,22 and 3 patients ; the patients of radiation group with 0,1,2,3,4 degree were 0,2,2,23 and 3 patients; in postoperative 1 week,the control group turned to 1,17,6,6 and 0 patients,the radiation group turned to 4,21,3,2 and 0 patients ; the difference between the 2 groups was not statistically significant (x2 =1.214,P =0.675) ; in postoperative 2 months,the patients with the above degree of dysphagia score of control group were 25,3,2,0,0; and the radiation group were 27,2,1,0,0,the difference between the 2 groups was not statistically significant (x2 =1.043,P =0.894).Followed up for 6 months,1 patient gastrointestinal bleeding,4 patients gastrointestinal pain and 8 patients esophageal restenosis were occurred in control group,corresponding in irradiated group were 0,5,and 3 patients respectively,the incidence of postoperative esophageal restenosis of irradiated group was lower than control group,and the difference was statistically significant (x2 =4.384,P =0.036).After follow-up for 18 months,10 patients were survival among the 30 patients of control group,the live time of the 20 patients dead patients were 2 to 14 months,control group of 30 patients,10 patients of survival of 20 deaths of patients from 2 to 14 months,the average value was (4.8± 1.7)months ; there were 15 survival patients among irradiation group,the survival time of the 15 deaths was 4 to 15 months,and the average value was (9.8 ± 2.9) months.By the end of follow-up,the average survival time for all patients of irradiated group was longer than the control group,the difference was statistically significant (t =8.917,P =0.002).Conclusion In patients with postoperative esophageal stricture and advanced esophageal cancer,stent loaded with 125I stent has potential benefit in that it allows a longer relief of dysphagia and a longer survival time. Key words: Esophageal neoplasms ;  Stents ;  Esophageal stenosis