Effectiveness of percutaneous metal stent placement in cholangiocarcinoma patients with midterm follow-up: Single center experience.

PURPOSE: Patients with advanced cholangiocarcinoma present with high rate of local complications. The primary aim of this study is to report clinical course of advanced cholangiocarcinoma patients those who were presented with biliary obstruction and treated with percutaneous biliary stenting. MATERIAL AND METHODS: Patients with unresectable locally advanced or metastatic cholangiocarcinoma followed by our center for a period of 4 years were analyzed. For statistical analysis demographic and clinical characteristics of patients, primary biliary drainage method, metal stent occlusion rate, time to stent occlusion, and overall survival rates were recorded. RESULTS: A total of 34 eligible patients were analyzed. 27 patients had metal stent placement. These 27 patients formed the basis of this study. Median overall survival (OS) was 6.0 months. After metal stent deployment bilurubin levels were normalized within a mean of 10 days. During the follow-up period, 13 patients were experienced metal stent occlusion. Median TtSO was 10 weeks. Cytotoxic chemotherapy was administered to 14 (52%) patients. Patients without stent dysfunction had significantly higher rate of chemotherapy exposure rate (p=0.021). Statistical analysis, however, failed to exhibit significant effect of stent dysfunction on OS. CONCLUSION: In advanced cholangiocarcinoma, relief of bile duct obstruction is an important part of the initial patient management. This study therefore described the clinical value of percutaneous metal stent in cholangiocarcinoma patients and raises the question about patency of metal stent in cholangiocarcinoma whether we can expect success similar to the success achieved in pancreas carcinoma.

Weekly cisplatin versus standard three-weekly cisplatin in concurrent chemoradiotherapy of head and neck cancer: the Baskent University experience.

BACKGROUND: The majority of patients with head and neck cancer are treated with concurrent chemoradiotherapy. However, toxicity is substantial so that alternate schedules of cisplatin have been tried to overcome this problem. No formal comparison, however, has been reported between alternate schedules and reference regimen. PATIENTS AND METHODS: Fifty-five eligible patients treated with concurrent chemoradiotherapy were retrospectively analyzed. The patients treated with weekly cisplatin were defined as group A, while the patients treated with standard regimen were defined as group B. Basic demographics and clinical characteristics', overall survival rate, locoregional or systemic relapse rates, and time to local/systemic relapse were recorded. RESULTS: One, two, and three-year probability of survival in groups A and B were 75% to 65% after one year, 63% to 56%after two, and 63% to 52% after three, respectively. Although time to local and systemic relapse was higher in group B as compared to group A, a statistical analysis was failed to show any significant difference. Furthermore, there was no significant difference between groups with respect to major toxicity. CONCLUSION: In patients with head and neck cancer, concurrent chemoradiotherapy with weekly cisplatin might be as effective as concurrent chemoradiotherapy with bolus cisplatin.