In the EPLBD without EST group, there were 36 patients in the EPLBD with a larger balloon (>15 mm) group and 129 patients in the EPLBD with a smaller balloon (12–15 mm) group. The safety variables did not differ significantly between the two groups, and no severe to fatal adverse event occurred in either group. Conclusion: Our study shows selleck chemical that EPLBD with a larger balloon (>15 mm) tends to have more risk of severe to fatal adverse events compared with a smaller balloon (12–15 mm) for removing

large bile duct stones. Large multicenter trials will be needed to reveal the statistical relationships between adverse events and balloon size. Key Word(s): 1. endoscopic large balloon dilation (EPLBD); 2. adverse events; 3. balloon size Presenting Author: YOUN JOO KIM Additional Authors: JIN SUN SHIN, KI YOUNG YANG Corresponding Author: YOUNJOO KIM Affiliations: Korea Cancer Center Hospital,

Korea Cancer Center Hospital Objective: Despite improvements in chemoradiation, local control remains a major KU-57788 clinical trial clinical problem in locally advanced or R1 resected cholangiocarcinoma (CC). The Hedgehog (HH) pathway has been implicated in tumor recurrence by promoting survival of tumorigenic precursors and through effects on tumor-associated stroma. Methods: We evaluated the radiosensitizing effects of a targeted Hedgehog inhibitor (Cyclopamine) or SMO RNA interference on proliferation, migration of cholangiocarcinoma cell lines in vitro. In vivo nude mice experiments were conducted using two groups: HuCCT-1-single implant xenograft (SX) and co-implant xenograft (CX) with HuCCT-1 and Lx-2. Results: In 4 CC cell lines in vitro, cyclopamine showed little

C-X-C chemokine receptor type 7 (CXCR-7) or no effect on radiosensitivity. By contrast, In co-cultured with Lx-2, LI 90 (human hepatic stellate cell lines), HH signal inhibition increased cancer cell suppression effect of radiation. In the human tumor xenograft models, cyclo pamine enhanced radiation efficacy and delayed tumor growth in CX, but not in SX. Cyclopamine treatment decreased CC cell proliferation, suppressed microvessel density, and increased apoptosis in the CX group, but not in the SX group. Conclusion: Targeted Hedgehog pathway inhibition can increase in vivo radiation efficacy in cholangiocarcinoma preclinical models. This effect is associated with pathway suppression in tumor-stroma interaction. These data support clinical testing of Hedgehog inhibitors as a component of multimodality therapy for locally advanced cholangiocarcinoma. Key Word(s): 1. hedgehog; 2. cholangiocarcinoma; 3.