title: A study of carboplatin-coated tube for the unresectable cholangiocarcinoma.
abstract: Most cases of cholangiocarcinoma have reached an unresectable stage by the time they are discovered despite significant progress of diagnostic modalities. Many of these patients with obstructive jaundice are often treated by biliary drainage using stents to relieve the jaundice. However, the stent patency period is as short as 3 to 9 months because of tumor ingrowth or overgrowth, and mean survival is at most 12 months. Therefore, both continuous relief of obstructive jaundice and local control of the tumor are required in the treatment for advanced cholangiocarcinoma. In this investigation, we developed a new percutaneous transhepatic biliary drainage tube coated with carboplatin (carboplatin-coated tube; CCT). CCT continuously released a fixed amount of carboplatin for 4 weeks and showed an antitumor effect on human cholangiocarcinoma cell line HuCC-T1 in vitro. When CCT was embedded in subcutaneous tumor inoculated in nude mice, a significant reduction of tumor size with no apparent damage to normal adjacent tissue was observed. On the basis of these studies, 5 patients with inoperable cholangiocarcinoma were treated with CCT for 4 weeks. Overall efficacy rate of 5 patients with cholangiocarcinoma was 60% (partial response in 3 and no change in 2). No apparent side effect was observed in these patients. Thus, CCT may provide a new treatment modality for this disease. Randomized controlled trials comparing CCT therapy with palliative stenting are required to confirm these results.
authors.affiliation: Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Mezawa
authors.forename: H
authors.initials: H
authors.lastname: Homma
authors.forename: T
authors.initials: T
authors.lastname: Sato
authors.forename: T
authors.initials: T
authors.lastname: Doi
authors.forename: K
authors.initials: K
authors.lastname: Miyanishi
authors.forename: K
authors.initials: K
authors.lastname: Takada
authors.forename: T
authors.initials: T
authors.lastname: Kukitsu
authors.forename: K
authors.initials: K
authors.lastname: Murase
authors.forename: N
authors.initials: N
authors.lastname: Yoshizaki
authors.forename: M
authors.initials: M
authors.lastname: Takahashi
authors.forename: S
authors.initials: S
authors.lastname: Sakamaki
authors.forename: Y
authors.initials: Y
authors.lastname: Niitsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D016190:Carboplatin / Q000008:administration & dosage* / Q000627:therapeutic use; D018281:Cholangiocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D051379:Mice; D008819:Mice, Nude; D008875:Middle Aged; D009368:Neoplasm Transplantation; D015607:Stents; D014407:Tumor Cells, Cultured / Q000187:drug effects
chemical_list: D000970:Antineoplastic Agents; D020099:Coated Materials, Biocompatible; D003692:Delayed-Action Preparations; D016190:Carboplatin