Objective: Evaluation of the effect of brachytherapy (Iridium-192) combined with insertion of a metal stent in a prospective randomized study. Material and methods: A total of 76 patients were treated. The etiology of stenosis was in all confirmed by histological examination. 38 patients with an inoperable malignant stenosis of the biliary pathways (group A) was treated by percutaneous implantation of a stent (Wallstent, spiral Z stent) and subsequent brachytherapy (Ir-192, mean dose 30 Gy). 38 patients (group B) had a Wallstent only without subsequent irradiation. Results: The mean survival time of patients (group A) was 291.2 days and 195.1 days (group B). From the statistical evaluation patients who died within one month were eliminated. Conclusion: A combination of percutaneous insertion of a stent and subsequent radiotherapy prolongs significantly the life span of patients with malignant stenosis of the biliary pathways treated by insertion of a metal stent. The most marked difference was recorded in patients with cholangiocarcinoma (339.8 A vs. 298 B).

        Key words: stent - brachytherapy - radiotherapy - malignant stenosis - biliary pathways