[Regional chemotherapy in the treatment of biliary tract tumors].
BACKGROUND
Subjective complaints of patients with tumours of the biliary tree are late, early diagnosis is difficult and frequently impossible, the therapeutic results are unsatisfactory and the prognosis is poor. Surgical intervention is in more than 90% palliative, the tumours are not radiosensitive and their sensitivity to systemically administered cytostatics is low. The perspective of some patients was improved by implantation of bilioduodenal endoprostheses. The objective of the submitted work was to assemble experience with this method in patients with tumours of the upper portions of the biliary tree.


RESULTS
Between January 1991 and May 1993 75 patients (42 females and 33 males, aged 48-65 years) with malignancies of the upper and middle part of the biliary tree were treated. Bilioduodenal endoprostheses (BDE) were inserted endoscopically in 70 patients. In 21 of them stenting was combined with regional chemotherapy via an implantable portho catheter. For patients with BDE alone, the median survival time was 18 months, for those with BDE and chemotherapy the median survival was 23 months (p < 0.01). 5-fluorouracil in monocombination was as potent as in combination with carmustine and/or doxorubicin.


CONCLUSIONS
Endoscopic implantation of a bilioduodenal endoprosthesis with subsequent regional administration of 5-fluorouracil is an important therapeutic procedure in the treatment of malignant tumours of the upper and middle biliary tree.
Dufek
V
V
I. interní klinika 1. LF UK, Praha.
Klener
P
P
Pesková
M
M
Spicák
J
J
Petrtýl
J
J
Chmel
J
J
Jirásek
V
V
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001661:Biliary Tract Neoplasms / Q000188:drug therapy*; D010478:Chemotherapy, Cancer, Regional Perfusion; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
Prínos regionální chemotherapie v lécbĕ nádorů biliárního systému.