Photodynamic Therapy Plus Chemotherapy Compared with Photodynamic Therapy Alone in Hilar Nonresectable Cholangiocarcinoma.
- Author:
Robert WENTRUP
1
;
Nicola WINKELMANN
;
Andrey MITROSHKIN
;
Matthias PRAGER
;
Winfried VODERHOLZER
;
Guido SCHACHSCHAL
;
Christian JÜRGENSEN
;
Carsten BÜNING
Author Information
1. Department of Internal Medicine, Waldfriede Hospital, Berlin, Germany. c.buening@waldfriede.de
- Publication Type:Original Article
- Keywords:
Nonresectable cholangiocarcinoma;
Photochemotherapy;
Chemotherapy;
Survival
- MeSH:
Bismuth;
Cholangiocarcinoma*;
Drug Therapy*;
Humans;
Mortality;
Photochemotherapy*;
Retrospective Studies;
Survival Rate
- From:Gut and Liver
2016;10(3):470-475
- CountryRepublic of Korea
- Language:English
-
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.
