The efficacy and safety of 125I seeds combined with biliary stent placement versus stent placement alone for malignant biliary obstruction: a systematic review and meta-analysis
Notice bibliographique
Résumé
Background: Currently, it is unknown whether iodine-125 (125I) stent implantation has the same therapeutic effect on patients with malignant biliary obstruction (MBO) caused by different cancers.This meta-analysis aimed to investigate whether 125I implantation in patients with MBO is superior to biliary stent placement in efficacy and safety, and to further explore the difference in efficacy and safety of seed implantation in different patients through subgroup analysis. Methods: A systematic search of the PubMed, Wiley Online Library, Cochrane library, Google Scholar, the Web of Science, China National Knowledge Infrastructure (CNKI), VIP, and Wanfang databases was conducted to screen all relevant studies up to October 30, 2022. Articles were not subjected to language or geographical limitations, but were required to meet the inclusion and exclusion criteria for this study. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of articles. The primary endpoint was survival, which was defined as the interval between initial treatment and death or the end of study. Meta analysis was performed using Stata/SE15.0. Results: A total of12 eligible studies were enrolled including 679 patients. All the included studies were single-center studies carried out in China.The results showed that the death risk and stent occlusion risk in the 125I group was 0.441 times [95% confidence interval (CI): 0.315 to 0.619, P<0.001; I2=0%, fixed, IV] and 0.534 times (95% CI: 0.433 to 0.658, P=0.003; I2=45.4%, fixed, IV) lower than the control group, respectively. There was no significant statistical difference in the risk of complications between the 2 groups [risk ratio (RR) =1.024, 95% CI: 0.963 to 1.090, P=0.450; PQ=0.640; I2=0%]. The reduction level of total bilirubin [TBIL; weighted mean differences (WMDs) =−14.969, 95% CI: −28.670 to −1.267, P=0.032; PQ=0.409, I2=2.1%) and aspartate transaminase (AST; WMD =−14.653, 95% CI: −23.246 to −6.060, P=0.001; PQ=0.900, I2=0%) in the 125I group was higher than that in the control group 1 week after surgery. The efficacy and safety of 125I for MBO patients were found to be independent of the type of tumor causing MBO (P for meta regression >0.05). Conclusions: For patients with MBO caused by hilar tumor or other tumors, 125I seed implantation can reduce the death risk and stent occlusion risk, prolong the time of survival and stent patency, and does not increase the complication risk. Due to the limitations of the study population, these findings should be further validated in other populations and regions.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,009 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».