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- Title
Comparison between regular additional endobiliary radiofrequency ablation and photodynamic therapy in patients with advanced extrahepatic cholangiocarcinoma under systemic chemotherapy.
- Authors
Möhring, Christian; Khan, Oliver; Taotao Zhou; Sadeghlar, Farsaneh; Mahn, Robert; Kaczmarek, Dominik J.; Dold, Leona; Toma, Marieta; Marinova, Milka; Glowka, Tim R.; Matthaei, Hanno; Manekeller, Steffen; Kalff, Jörg C.; Strassburg, Christian P.; Weismüller, Tobias J.; Gonzalez-Carmona, Maria A.
- Abstract
Background and aims: Extrahepatic cholangiocarcinoma (eCCA) remains a malignancy with a dismal prognosis. The first-line standard of care includes systemic chemotherapy (SC) and biliary drainage through stenting. Endobiliary ablative techniques, such as photodynamic therapy (ePDT) and radio-frequency ablation (eRFA), have demonstrated feasibility and favorable survival data. This study aimed to compare the oncologic outcome in patients treated with SC and concomitant eRFA or ePDT. Method: All patients with eCCA were evaluated for study inclusion. Sixty-three patients receiving a combination of SC and at least one endobiliary treatment were retrospectively compared. Results: Patients were stratified into three groups: SC + ePDT (n = 22), SC + eRFA (n = 28), and SC + ePDT + eRFA (n = 13). The median overall survival (OS) of the whole cohort was 14.2 months with no statistically significant difference between the three therapy groups but a trend to better survival for the group receiving ePDT as well as eRFA, during SC (ePDT + SC, 12.7 months; eRFA + SC, 13.8 months; ePDT + eRFA + SC, 20.2 months; p = 0.112). The multivariate Cox regression and subgroup analysis highlighted the beneficial effect of eRFA on OS. Overall, combined therapy was well tolerated. Only cholangitis occurred more often in the SC + eRFA group. Conclusion: Additional endobiliary ablative therapies in combination with SC were feasible. Both modalities, eRFA and ePDT, showed a similar benefit in terms of survival. Interestingly, patients receiving both regimes showed the best OS indicating a possible synergism between both ablative therapeutic techniques.
- Subjects
CANCER chemotherapy; PHOTODYNAMIC therapy; ABLATION techniques; CATHETER ablation; CHOLANGIOCARCINOMA
- Publication
Frontiers in Oncology, 2023, p1
- ISSN
2234-943X
- Publication type
Article
- DOI
10.3389/fonc.2023.1227036