Gut Liver.  2014 May;8(3):318-323.

Long-Term Outcome of Photodynamic Therapy with Systemic Chemotherapy Compared to Photodynamic Therapy Alone in Patients with Advanced Hilar Cholangiocarcinoma

• Hong MJ
• Cheon YK
• Lee EJ
• Lee TY
• Shim CS

Abstract

BACKGROUND/AIMS
Patients with cholangiocarcinoma usually present at an advanced stage, and more than 50% of cases are not resectable at the time of diagnosis. Recently, photodynamic therapy (PDT) has been proposed as a palliative and neoadjuvant modality. We evaluated whether combination of PDT and chemotherapy is more effective than PDT alone.
METHODS
In total, 161 patients with cholangiocarcinoma diagnosed between February 1999 and September 2009 were evaluated. Sixteen patients were treated with PDT and chemotherapy (group A), and 58 were treated with PDT (group B).
RESULTS
The median survival was 538 days (95% confidence interval [CI], 475.3 to 600.7) in group A and 334 days (95% CI, 252.5 to 415.5) in group B (p=0.05). Lymph node metastasis status, serum bilirubin of pretreatment, tumor node metastasis stage, treatment method (PDT with chemotherapy vs PDT alone), time to PDT and the number of PDT sessions were prognostic factors with statistical significance in the univariate analysis. A multivariate analysis showed that PDT with chemotherapy and more than two sessions of PDT were significant independent predictors of longer survival in advanced cholangiocarcinoma (hazard ratio [HR], 2.23; 95% CI, 1.18 to 4.20; p=0.013 vs HR, 1.79; 95% CI, 1.044 to 3.083; p=0.034).
CONCLUSIONS
PDT with chemotherapy results in longer survival than PDT alone.

Keyword

Cholangiocarcinoma; Photochemotherapy; Drug therapy

MeSH Terms

Adult
Aged
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
Bile Duct Neoplasms/*drug therapy
*Bile Ducts, Intrahepatic
Cholangiocarcinoma/*drug therapy/mortality
Cholangiopancreatography, Endoscopic Retrograde
Cisplatin/administration & dosage
Combined Modality Therapy/mortality
Deoxycytidine/administration & dosage/analogs & derivatives
Female
Fluorouracil/administration & dosage
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Photochemotherapy/*methods/mortality
Treatment Outcome
Cisplatin
Deoxycytidine
Fluorouracil