Percutaneous stenting for malignant biliary stenosis

Percutaneous stenting for malignant biliary stenosis is quite beneficial to patients with unresectable or recurrent disease, tremendously improving the quality of their lives. Percutaneous transhepatic biliary drainage (PTBD) was attempted in 92 patients with obstructive jaundice during the period between January 1986 and July 1989. Implantation of an endoprosthesis was performed in 14 cases (15.2%) and succeeded in 12 (85.7%). When a guide wire could not be passed distally across the stricture site, percutaneous transhepatic cholangioscopy (PTCS) through the dilated PTBD fistula was carried out to enable its passage. PTCS is also valuable in the preoperative diagnosis of obstructive jaundice. The patients who are not candidates for surgery are suitable for this procedure. A Miller double-mushroom stent is used as the endoprosthesis in the majority of cases. One patient with recurrent hepatoma has lived at home with this stent for greater than 3 years due to repeated transarterial embolization and chemotherapy and does not need to wash or change the stent.

[Clinical study of preoperative chemotherapy of primary breast cancer. 1. Efficacy of a combined use of CPA (endoxan) and FT-207 (or 5-FU dry syrup)]

In twenty-nine cases of primary breast cancer preoperative treatment using CPA and FT-207 (or 5-FUDS) was performed to determine their efficacy. Daily dose of each anticancer drugs was as follows: CPA 50-200 mg, FT-207 200-600 mg, 5-FUDS 200 mg, p.o.. The total doses were CPA 1.8 g, FT-207 5.0g, 5-FUDS 3.4 g in average. In 11 cases (37.9%) reduction in tumor size was obtained. According to Ohboshi's criteria, over Grade II a effect was seen in 5 cases (17.2%), while Grade III effect was not seen in any of the cases. Effective cases were more frequently observed among those which received CPA at 25 mg/kg or more, or FT-207 (5-FUDS) at 80 mg/kg or more. Main side effects were G. I tract symptoms such as anorexia and nausea. To obtain definitive conclusion on the clinical significance of use of CPA and FT-207 (5-FUDS) as preoperative chemotherapy for breast cancer, further studies are required.