Palliation of Nonresectable Bile Duct Cancer: Improved Survival After Photodynamic Therapy

Abstract

PDT is minimally invasive but shows a considerable postinterventional cholangitis rate. PDT has the potential to result in a changeover of current palliative treatment of BDC.

Synergic effect of photodynamic therapy using talaporfin sodium with conventional anticancer chemotherapy for the treatment of bile duct carcinoma

“…1 PDT is technically feasible and is a useful modality for treating non-resectable or resectable bile duct carcinomas (BDC). [2][3][4][5] Remarkably, PDT treatment induces a powerful anti-tumor immunological response. 6 In two randomized controlled trials, PDT provided a longer survival.…”

“…6 In two randomized controlled trials, PDT provided a longer survival. 4,5 PDT treatment benefits have been reported for treating the targeted area in BDC patients who are receiving chemotherapy or adjuvant chemotherapy after surgery. 7,8 Thus, PDT should be a promising treatment modality to augment the conventional anticancer chemotherapy and brachytherapy as recommended in the 2009 Japanese BDC treatment guidelines.…”

“…9 The first clinically approved photosensitizer, porfimer sodium (Photofrin ® ), is a hematoporphyrin derivative and has a very powerful cytocidal effect in BDC. [1][2][3][4][5][6][7][8] However, the anti-tumor effect was limited to the shallow bile duct wall because the 630 nm laser used in treatment had a low permeability. 10 Furthermore, the long period of skin photosensitivity required the patients to be kept away from strong sunlight for several weeks following the drug administration.…”

387 Safety and Efficacy of Radiofrequency Ablation in the Management of Unresectable Bile Duct and Pancreatic Cancer: A Novel Palliation Technique

“…SEMS have been shown to offer longer palliation than plastic stents but can occlude due to tumor growth, sludge or biofilm formation. In patients with cholangiocarcinoma, PDT has shown improvement in overall survival; however, it is also associated with complications such as cholangitis, hemobilia, and photosensitivity (12.5-30%) [13,14].…”

“…Another treatment strategy to prolong stent patency and eventual survival is photodynamic therapy (PDT). PDT showed promising results; however, it carries a high complication rate including cholangitis and photosensitivity requiring the patient to avoid direct exposure to light for 4-6 weeks [12][13][14].…”