A study of carboplatin-coated tube for the unresectable cholangiocarcinoma

Most cases of cholangiocarcinoma have reached an unresectable stage by the time they are discovered despite significant progress of diagnostic modalit ies, Many of these patients with obstructive jaundice are often treated by biliary drainage using stents to relieve the jaundice. However, the stent p atency period is as short as 3 to 9 months because of tumor ingrowth or ove rgrowth, 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, w e developed a new percutaneous transhepatic biliary drainage tube coated wi th carboplatin (carboplatin-coated tube; CCT). CCT continuously released a fixed amount of carboplatin for 4 weeks and showed an antitumor effect on h uman cholangiocarcinoma cell line HuCC-T1 in vitro, When CCT was embedded i n subcutaneous tumor inoculated in nude mice, a significant reduction of tu mor 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 com paring CCT therapy with palliative stenting are required to confirm these r esults.