No abstract available
Bile Duct Neoplasms/*drug therapy/mortality ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*drug therapy/mortality ; Humans ; *Photochemotherapy ; Survival Rate

BACKGROUND/AIMS: Photodynamic therapy (PDT) has a promising effect on non-resectable hilar cholangiocarcinoma. The aim of this study was to compare overall survival of PDT plus biliary drainage versus biliary stent alone in advanced hilar cholangiocarcinoma. METHODS: Twenty patients who were treated with endoscopic biliary drainage alone (Group A) and 27 patients treated with PDT under percutaneous cholangioscopy and additional percutaneous biliary drainage (Group B) were analyzed retrospectively. RESULTS: The mean bilirubin level declined effectively in both group after treatment. One-year survival was 28% in group A, 52% in group B (p<0.05). Median survival time was 288 days in group A, 558 days in group B (p=0.0143). CONCLUSIONS: PDT under percutaneous cholangioscopy seems to be more effective in extending survival than biliary drainage alone in advanced hilar tumor. To investigate whether PDT can increase survival rates, further prospective, randomized study is needed.
Aged ; Bile Duct Neoplasms/mortality/*therapy ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/mortality/*therapy ; Comparative Study ; *Drainage ; Endoscopy ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; *Photochemotherapy ; Stents ; Survival Rate

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.
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