The Efficacy And Safety Of ¹²⁵I Seeds Brachytherapy For Malignant Obstructive Jaundice:A Meta-analysis

Objective:To evaluate the efficacy and safety of ¹²⁵I seeds brachytherapy in the treatment of malignant obstructive jaundice（MOJ）with meta-analysis.Method:We searched published randomized controlled trials（RCTs）of¹²⁵I seeds brachytherapy In the treatment of MOJ in the databases:CBM,Wan Fang Data,CNKI,VIP,PubMed,the Cochrane library,Embase,Ovid from inception to March 2018.Two researchers independently screened literature,assessed the quality of the included studies and extracted data,statistical analysis was performed with Rev Men5.3 software.Results:A total of 15 RCTs including 1015 patients were involved.Meta-analysis showed that:1 year survival rate in ¹²⁵I brachytherapy group was higher than the control group（RR=2.06,95%CI:1.62².62,P<0.00001）,and survival risk is lower than the control group（HR=0.38,95%CI:0.26⁰.57,P<0.00001）.The total bilirubin（TBIL）of 1 month after operation（WMD=-6.08,95%CI:-9.05^-3.10,P<0.0001）,the TBIL of3 months after operation（WMD=-37.72,95%CI:-44.99^-30.45,P<0.00001）in ¹²⁵I radiation group ware lower than the control group,biliary patency in ¹²⁵I brachytherapy group was better than the control group.A month after operation,the tumor size decreased in ¹²⁵I brachytherapy group,but that increased in the control group（SMD=-2.77,95%CI:-5.10⁰.44,P=0.02）.The rate of pain relief in ¹²⁵I brachytherapy group was significantly higher than the control group（RR=21.08,95%CI:4.43¹00.16,P=0.0001）.There ware no significant differences of alanine aminotransferase（ALT）one month after operation（WMD=-3.06,95%CI:-7.97¹.85,P=0.22）and the common postoperative complication rate（RR=0.96,95%CI:0.68¹.35,P=0.80）.Conclusions:Compared with single stent and biliary drainage,¹²⁵I brachytherapy can effectively prolong the survival,improve the biliary patency,inhibit tumor growth,while not damage to the liver function and increase complications.