Efficacy Analysis Of Biliary Stent Combined With Stereotactic Body Radiotherapy In The Treatment Of Locally Advanced Cholangiocarcinoma

Objective:In this paper,patients with locally advanced unresectable cholangiocarcinoma were selected as the research objects to discuss the efficacy of simple biliary stent implantation and biliary stent combined with stereotactic body radiotherapy on such patients,as well as to analyze related prognostic factors and complications.Methods:Retrospective analysis was performed on the clinical data of 49 patients with unresectable,locally advanced cholangiocarcinoma treated in the Fifth Affiliated Hospital of Zhengzhou University from January 2015 to June 2018.Patients in the control group received percutaneous biliary stent implantation(PTBS),while patients in the experimental group received percutaneous biliary stent implantation(PTBS)combined with stereotactic body radiotherapy(SBRT),with the prescription dose of 36?48Gy and 3?4Gy/fraction,for a total of 12?14 times.After that,liver function was reviewed at the first month after treatment,and abdominal enhanced CT was reviewed every 3 months thereafter.All patients were followed up,with SPSS 23.0 statistical software used for statistical analysis.Results:1.Observation of efficacy:(1)Short-term efficacy of radiotherapy:At the 3-month review,13 cases were complete remission and 9 cases were partial remission,with an objective remission rate of 88%.At 6-month follow-up,12 patients were complete remission,7 were partial remission,with an objective remission rate of 76%.(2)Clinical efficacy evaluation:1)Jaundice and bilirubin levels:After treatment,the decrease rate of jaundice symptoms in the two groups was 100%.After 1 month of treatment,the total bilirubin and direct bilirubin values in the two groups were significantly lower than before treatment(P<0.05);2)Values of alanine aminotransferase and aspartate aminotransferase:After 1 month of treatment,the average values of alanine aminotransferase and aspartate aminotransferase in the control group and the experimental group were lower than before,and the two indexes were compared between the two groups,and the changes before and after treatment were statistically significant(P<0.05);3)Albumin:Changes in albumin levels between the control group and the experimental group before and 1 month after treatment were analyzed,and the difference was significant(P<0.05).2.Survival time:The median survival time was 6.0 months in the control group and 16 months in the experimental group,and the 1-year survival rate was 12.5%and 64%,respectively.There was a statistical difference in the overall survival time between the two groups(P<0.05).Univariate analysis showed that gender,preoperative albumin and total bilirubin levels,different treatment methods and tumor size were important factors affecting the total survival time.Multivariate analysis showed that preoperative albumin and total bilirubin levels,tumor size and treatment mode were important independent factors affecting the prognosis,and further confirmed that PTBS combined with stereotactic body radiotherapy was an independent protective factor.3.Complications:No serious and fatal complications were found in the two groups,which were relieved after symptomatic treatment.Conclusions:With simply biliary stenting,biliary stent combined with stereotactic body radiotherapy could significantly alleviate the symptoms of patients with locally advanced cholangiocarcinoma such as jaundice caused by biliary obstruction,reduce the levels of total bilirubin and direct bilirubin,improve liver function,improve the tumor local control at the same time,and then make its clinical benefit,prolong the overall survival of patients with the class.