Outcomes of two types of iodine-125 seed delivery with metal stents in treating malignant biliary obstruction: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#humans #iodine-radioisotopes #cholestasis #stents #treatment-outcome

Outcomes of two types of iodine-125 seed delivery with metal stents in treating malignant biliary obstruction: a systematic review and meta-analysis

Fu et al., 2023 | Diagn Interv Radiol | Meta Analysis

Citation

Fu Xiaobo, Qi Han, ... Gao Fei. Outcomes of two types of iodine-125 seed delivery with metal stents in treating malignant biliary obstruction: a systematic review and meta-analysis. Diagn Interv Radiol. 2023-May-31;29(3):509-519. doi:10.5152/dir.2022.211277

Abstract

PURPOSE: To conduct a meta-analysis comparing the efficacy and safety of two types of iodine-125 (I-125) seed delivery with metal stents (the study group) versus conventional metal stents (the control group) in patients with malignant biliary obstruction (MBO). METHODS: Our team systematically searched the PubMed, Embase, and Cochrane Library databases for relevant studies published from January 2012 up to July 2021. Survival time and stent dysfunction were the primary measured outcomes. Subgroup analyses were conducted according to the type of I-125 seed delivery. RESULTS: Eleven studies, including 1057 patients in total, were pooled for stent dysfunction. The study group showed a lower risk of stent dysfunction than the control group [odds ratio (OR): 0.61, 95% confidence interval (CI) 0.46-0.81, P = 0.001]. The pooled results of six studies reporting overall survival (OS) showed that the study group had a better survival outcome than the control group [hazard ratio (HR): 0.34, 95% CI: 0.28-0.42, P < 0.001]. In the subgroup analyses, the I-125 seed stent group had significantly less stent dysfunction than the control group (OR: 0.49, 95% CI: 0.31-0.76, P = 0.002). Meanwhile, the metal stents + I-125 radioactive seed strand group showed significantly more improvement in OS than the control group (HR: 0.33, 95% CI: 0.26-0.42, P < 0.001). Moreover, our analysis suggests that using I-125 seeds did not result in increasing related adverse events compared with using metal stents alone (all P > 0.05). The study group was significantly superior to the control group, with better survival and decreased stent dysfunction. Meanwhile, the delivery of I-125 seeds did not increase adverse events. CONCLUSION: The delivery of I-125 with metal stents may be considered a preferable technique for MBO.

Key Findings

Eleven studies, including 1057 patients in total, were pooled for stent dysfunction. The study group showed a lower risk of stent dysfunction than the control group [odds ratio (OR): 0.61, 95% confidence interval (CI) 0.46-0.81, P = 0.001]. The pooled results of six studies reporting overall survival (OS) showed that the study group had a better survival outcome than the control group [hazard ratio (HR): 0.34, 95% CI: 0.28-0.42, P < 0.001]. In the subgroup analyses, the I-125 seed stent group ha

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population malignant biliary obstruction
Sample Size 1057
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Iodine Radioisotopes
  • Cholestasis
  • Stents
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Meta-Analysis, Systematic Review, Journal Article
  • Vertical: iodine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09