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- Title
Biliary drainage, photodynamic therapy and chemotherapy for unresectable cholangiocarcinoma with jaundice.
- Authors
Fuks, David; Bartoli, Eric; Delcenserie, Richard; Yzet, Thierry; Celice, Pierre; Sabbagh, Charles; Chatelain, Denis; Joly, Jean-Paul; Cheron, Nathalie; Dupas, Jean-Louis; Regimbeau, Jean-Marc
- Abstract
Background and Aim: The combination of photodynamic therapy and biliary stenting seems to be beneficial in the palliative treatment of unresectable cholangiocarcinoma. We aimed to assess the accuracy of photodynamic therapy in a single centre. Methods: Fourteen selected patients, with jaundice related to unresectable cholangiocarcinoma, underwent photodynamic therapy and biliary stenting (with or without chemotherapy). Photofrin was injected intravenously (2 mg/kg) 2 days before intraluminal photoactivation. In case of malignant progression, photodynamic therapy was repeated. The outcome parameters were overall survival and quality of life. Results: There were eight men and six women (median age: 67 [42–81]). Unresectability was related to a low Karnofski index ( n = 2), peritoneal carcinomatosis ( n = 4), vascular involvement ( n = 3), invasion of the hepatoduodenal ligament ( n = 2) and an under-sized liver remnant ( n = 3). Biliary stenting was efficient (≥ 50% total bilirubin) in 78.5% of cases. Eight patients developed cholangitis. The mean number of photodynamic therapy procedures was two (1–4). Six (43%) patients needed ≥ 2 procedures. No severe toxicity was noted. Photodynamic therapy improved the Karnofski index in 64% of cases. Six (42.8%) patients received concomitant chemotherapy (gemcitabine). The median survival time was 13.8 [0.7–29.2] months. The 3-, 6- and 12-month survival rates were 85%, 77% and 77%, respectively. Conclusion: These results confirm the beneficial effect of biliary drainage, photodynamic therapy and chemotherapy for unresectable cholangiocarcinoma in selected patients with jaundice.
- Subjects
CHOLANGIOCARCINOMA; PHOTOCHEMOTHERAPY; PALLIATIVE treatment; JAUNDICE; PATIENTS; THERAPEUTICS
- Publication
Journal of Gastroenterology & Hepatology, 2009, Vol 24, Issue 11, p1745
- ISSN
0815-9319
- Publication type
Article
- DOI
10.1111/j.1440-1746.2009.05915.x