Radioisotope Treatment for Benign Strictures of Non-vascular Luminal Organs

비혈관성 관강 장기의 양성 협착 질환의 방사성동위원소 치료

  • Shin, Ji-Hoon (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center)
  • 신지훈 (울산대학교 의과대학 방사선과학교실)
  • Published : 2006.04.29

Abstract

Tissue hyperplasia is one of the most frequently encountered complications when self-expanding metallic stents are placed in benign non-vascular luminal organ strictures, thus causing restenosis of the lumen. The investigators postulated that ionizing irradiation could be applied to prevent restenosis caused by tissue hyperplasia in non-vascular luminal organs as it reduced coronary or peripheral arterial narrowing successfully. The authors combined $\beta$-irradiation using $^{188}Re-MAG_3$ solution with balloon dilation for animal and clinical studies because this new treatment approach had the advantages such as low penetration depth of $\beta$-ray, self-centering irradiation, and mechanical effect of balloon dilation over using $\gamma$-irradiation with afterloading devices in this article, the concept and mechanism of radioisotope balloon dilation, and animal and clinical studies using radioisotope balloon dilation are reviewed.

Keywords

References

  1. Shin JH, Song HY, Kim JH, et al. Comparison of temporary and permanent stent placement with concurrent radiation therapy in patients with esophageal carcinoma. J Vasc Interv Radiol 2005;16:67-74 https://doi.org/10.1097/01.RVI.0000142585.90055.74
  2. Wang MQ, Sze DY, Wang ZP, Wang ZQ, Gao YA, Dake MD. Delayed complications after esophageal stent placement for treatment of malignant esophageal obstructions and esophagorespiratory fistulas. J Vasc Interv Radiol 2001;12: 465-74 https://doi.org/10.1016/S1051-0443(07)61886-7
  3. Ko GY, Kim GC, Seo TS, et al. Covered, retrievable, expandable urethral nitinol stent: feasibility study in dogs. Radiology 2002;223:83-90 https://doi.org/10.1148/radiol.2231010734
  4. Song HY, Park H, Suh TS, et al. Recurrent traumatic urethral strictures near the external sphincter: treatment with a covered, retrievable, expandable nitinol stent--initial results. Radiology 2003;226:433-40 https://doi.org/10.1148/radiol.2262012160
  5. Song HY, Park SI, Do YS, et al. Expandable metallic stent placement in patients with benign esophageal strictures: results of long-term follow-up. Radiology 1997;203:131-6 https://doi.org/10.1148/radiology.203.1.9122381
  6. Escarmant P, Zimmermann S, Amar A, et al. The treatment of 783 keloid scars by iridium 192 interstitial irradiation after surgical excision. Int J Radiat Oncol Biol Phys 1993; 26:245-51 https://doi.org/10.1016/0360-3016(93)90204-9
  7. Park SW, Hong MK, Moon DH, et al. Treatment of diffuse in-stent restenosis with rotational atherectomy followed by radiation therapy with a rhenium-188-mercaptoacetyltriglycine- filled balloon. J Am Coll Cardiol 2001;38:631-7 https://doi.org/10.1016/S0735-1097(01)01446-2
  8. Waksman R, Raizner AE, Yeung AC, Lansky AJ, Vandertie L. Use of localised intracoronary beta radiation in treatment of in-stent restenosis: the INHIBIT randomised controlled trial. Lancet 2002;359:551-7 https://doi.org/10.1016/S0140-6736(02)07741-3
  9. Kennedy AJ, Cherry DS, Zipper CE. Evaluation of ionic contribution to the toxicity of a coal-mine effluent using Ceriodaphnia dubia. Arch Environ Contam Toxicol 2005; 49:155-62 https://doi.org/10.1007/s00244-004-0034-z
  10. Kramer MR, Katz A, Yarmolovsky A, Schifter D, Fenig E. Successful use of high dose rate brachytherapy for non-malignant bronchial obstruction. Thorax 2001;56:415-6 https://doi.org/10.1136/thorax.56.5.415
  11. Olschewski T, Kropfl D, Seegenschmiedt MH. Endourethral brachytherapy for prevention of recurrent urethral stricture following internal urethrotomy--first clinical experiences and results. Int J Radiat Oncol Biol Phys 2003;57:1400-4 https://doi.org/10.1016/S0360-3016(03)00779-X
  12. Sun YH, Xu CL, Gao X, et al. Intraurethral brachytherapy for prevention of recurrent urethral stricture after internal urethrotomy or transurethral resection of scar. J Endourol 2001;15:859-61 https://doi.org/10.1089/089277901753205906
  13. Diamond DA, Vesely TM. The role of radiation therapy in the management of vascular restenosis. Part I. Biologic basis. J Vasc Interv Radiol 1998;9:199-208 https://doi.org/10.1016/S1051-0443(98)70259-3
  14. Waksman R, Robinson KA, Crocker IR, Gravanis MB, Cipolla GD, King SB, 3rd. Endovascular low-dose irradiation inhibits neointima formation after coronary artery balloon injury in swine. A possible role for radiation therapy in restenosis prevention. Circulation 1995;91:1533-9 https://doi.org/10.1161/01.CIR.91.5.1533
  15. Wilcox JN, Waksman R, King SB, Scott NA. The role of the adventitia in the arterial response to angioplasty: the effect of intravascular radiation. Int J Radiat Oncol Biol Phys 1996;36:789-96 https://doi.org/10.1016/S0360-3016(96)00299-4
  16. Kurkinen M, Vaheri A, Roberts PJ, Stenman S. Sequential appearance of fibronectin and collagen in experimental granulation tissue. Lab Invest 1980;43:47-51
  17. Mayoral W, Fleischer D, Salcedo J, Roy P, Al-Kawas F, Benjamin S. Nonmalignant obstruction is a common problem with metal stents in the treatment of esophageal cancer. Gastrointest Endosc 2000;51:556-9 https://doi.org/10.1016/S0016-5107(00)70289-6
  18. Liermann D, Bottcher HD, Kollath J, et al. Prophylactic endovascular radiotherapy to prevent intimal hyperplasia after stent implantation in femoropopliteal arteries. Cardiovasc Intervent Radiol 1994;17:12-6 https://doi.org/10.1007/BF01102065
  19. Jiang YL, Escano MF, Sasaki R, et al. Ionizing radiation induces a p53-dependent apoptotic mechanism in ARPE-19 cells. Jpn J Ophthalmol 2004;48:106-14 https://doi.org/10.1007/s10384-003-0043-x
  20. Langley RE, Bump EA, Quartuccio SG, Medeiros D, Braunhut SJ. Radiation-induced apoptosis in microvascular endothelial cells. Br J Cancer 1997;75:666-72 https://doi.org/10.1038/bjc.1997.119
  21. Matsuu M, Shichijo K, Okaichi K, et al. The protective effect of fermented milk kefir on radiation-induced apoptosis in colonic crypt cells of rats. J Radiat Res (Tokyo) 2003; 44:111-5 https://doi.org/10.1269/jrr.44.111
  22. Hang CL, Fu M, Hsieh BT, et al. Intracoronary beta- irradiation with liquid rhenium-188: results of the Taiwan radiation in prevention of post-pure balloon angioplasty restenosis study. Chest 2003;124:1284-93 https://doi.org/10.1378/chest.124.4.1284
  23. Hoher M, Wohrle J, Wohlfrom M, et al. Intracoronary beta- irradiation with a rhenium-188-filled balloon catheter: a randomized trial in patients with de novo and restenotic lesions. Circulation 2003;107:3022-7 https://doi.org/10.1161/01.CIR.0000074203.66371.29
  24. Shin JH, Song HY, Moon DH, et al. Reduction of tissue hyperplasia with a rhenium-188 mercaptoacetyltriglycine-3- filled balloon: preliminary study in a canine urethral model. J Vasc Interv Radiol 2004;15:737-43 https://doi.org/10.1097/01.RVI.0000133523.44219.95
  25. Shin JH OS, Kim JS, et al. Effects of irradiation using a radioisotope-filled balloon on tissue hyperplasia caused by stent placement in a canine urethral model. Acta Radiol (in press)
  26. Shin JH, Song HY, Moon DH, et al. Reduction of tissue hyperplasia with a $^{188}$Re-MAG3-filled balloon dilation: Experimental study with a rabbit esophageal model. J Korean Radiol Soc 2004;51:515-24 https://doi.org/10.3348/jkrs.2004.51.5.515
  27. Mandhani A, Chaudhury H, Kapoor R, Srivastava A, Dubey D, Kumar A. Can outcome of internal urethrotomy for short segment bulbar urethral stricture be predicted? J Urol 2005;173:1595-7 https://doi.org/10.1097/01.ju.0000154347.24230.f1