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Comparative Study
. 2016 May 23;10(3):470-5.
doi: 10.5009/gnl15175.

Photodynamic Therapy Plus Chemotherapy Compared with Photodynamic Therapy Alone in Hilar Nonresectable Cholangiocarcinoma

Robert Wentrup  1 , Nicola Winkelmann  2 , Andrey Mitroshkin  2 , Matthias Prager  2 , Winfried Voderholzer  3 , Guido Schachschal  4 , Christian Jürgensen  2 , Carsten Büning  1   2
Affiliations
Comparative Study

Photodynamic Therapy Plus Chemotherapy Compared with Photodynamic Therapy Alone in Hilar Nonresectable Cholangiocarcinoma

Robert Wentrup et al. Gut Liver. .

Abstract

Background/aims: Standard treatments are not available for hilar nonresectable cholangiocarcinoma (NCC). It is unknown whether combination therapy of photodynamic therapy (PDT) plus systemic chemotherapy is superior to PDT alone.

Methods: We retrospectively reviewed 68 patients with hilar NCC treated with either PDT plus chemotherapy (PTD-C) or PDT monotherapy (PDT-M). The primary endpoint was the mean overall survival rate. Secondary endpoints included the 1-year survival rate, risk of cholangitic complications, and outcomes, which were evaluated according to the chemotherapy protocol.

Results: More than 90% of the study population had advanced hilar NCC Bismuth type III or IV. In the PDT-M group (n=35), the mean survival time was 374 days compared with 520 days in the PDT-C group (n=33, p=0.021). The 1-year survival rate was significantly higher in the PDT-C group compared with the PDT-M group (88% vs 58%, p=0.001) with a significant reduction of mortality (hazard ratio, 0.20; 95% confidence interval, 0.07 to 0.58; p=0.003). Gemcitabine monotherapy resulted in a shorter survival time compared with the gemcitabine combination therapy (mean, 395 days vs 566 days; p=0.09). Cholangitic complications were observed at a similar frequency in the PDT-C and PDT-M groups.

Conclusions: Combining repeated PDT with a gemcitabine-based combination therapy might offer a significant survival benefit in patients with hilar NCC.

Keywords: Chemotherapy; Nonresectable cholangiocarcinoma; Photochemotherapy; Survival.

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Figures

Fig. 1
Fig. 1
Overall survival rate of the nonresectable cholangiocarcinoma patients with photodynamic monotherapy (PDT-M) and photodynamic plus chemotherapy (PDT-C) from the time of diagnosis until the time of death in days (p=0.021, Mann-Whitney U-test).
Fig. 2
Fig. 2
Overall survival rate in photodynamic monotherapy (PDT-M) and photodynamic plus chemotherapy (PDT-C) patients.
See this image and copyright information in PMC

References

    1. Khan SA, Thomas HC, Davidson BR, Taylor-Robinson SD. Cholangiocarcinoma. Lancet. 2005;366:1303–1314. doi: 10.1016/S0140-6736(05)67530-7. - DOI - PubMed
    1. Nakeeb A, Pitt HA, Sohn TA, et al. Cholangiocarcinoma: a spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg. 1996;224:463–473. doi: 10.1097/00000658-199610000-00005. - DOI - PMC - PubMed
    1. Ortner ME, Caca K, Berr F, et al. Successful photodynamic therapy for nonresectable cholangiocarcinoma: a randomized prospective study. Gastroenterology. 2003;125:1355–1363. doi: 10.1016/j.gastro.2003.07.015. - DOI - PubMed
    1. Kiba T, Nishimura T, Matsumoto S, et al. Single-agent gemcitabine for biliary tract cancers: study outcomes and systematic review of the literature. Oncology. 2006;70:358–365. doi: 10.1159/000098109. - DOI - PubMed
    1. Scheithauer W. Review of gemcitabine in biliary tract carcinoma. Semin Oncol. 2002;29(6 Suppl 20):40–45. doi: 10.1053/sonc.2002.37380. - DOI - PubMed

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