Meta-analysis Of The Efficacy Of Intracavitary Brachytherapy Compared With Stent In The Treatment Of Malignant Biliary Obstruction

Objective: to evaluate the therapeutic effect of radioactive stent irradiation on malignant obstructive disease compared with simple stent implantationMethods: search the PubMed,EMBASE,Cochrane Library,CNKI,wanfang,wip,and clinicaltrial.gov databases for relevant randomized controlled studies until March 1,2019,and complete subgroup analysis by study design and stent type.Results: seven randomized controlled studies comparing ILBT with simple stents were included,and a total of 615 MBO patients were included in our meta-analysis.Among them,306 patients were treated with intraluminal brachytherapy(ILBT),and 309 patients were treated with only stent(OR=0.25).95%CI: 0.11-0.56,P=0.0007),longer mean stent passage time(MD=3.91;95%CI: 3.34-4.48,P < 0.0001),mean survival time(MD = 2.97;95%CI: 2.09-3.85,P < 0.00001);However,the incidence of complications between the two groups and the postoperative direct bilirubin level decreased(MD =10.60;95% CI 8.57,29.97;P = 0.28),and the postoperative ALT level decreased(MD = 8.01).95% CI: 4.21 20.23;There was no significant difference between the two groups(P = 0.20),and the postoperative decrease level of total bilirubin was suspicious(MD = 36.01;95% CI: 5.75 66.27;P = 0.02).Conclusion: ILBT is superior to stent alone in the aspects of stent blockage,stent patency time and average survival time.At the same time,ILBT was almost the same as stent therapy in terms of complications and reduced TBIL,DBIL and ALT levels after treatment,and ILBT may be a better treatment for advanced palliative therapy in patients with MBO who cannot be surgically treated.