Literature DB >> 30637783

Combined photodynamic therapy with systemic chemotherapy for unresectable cholangiocarcinoma.

Maria Angeles Gonzalez-Carmona1, Maximilian Bolch1, Christian Jansen1, Annabelle Vogt1, Matthias Sampels1, Raphael U Mohr1, Katrin van Beekum1, Robert Mahn1, Michael Praktiknjo1, Jacob Nattermann1, Jonel Trebicka1,2, Vittorio Branchi3, Hanno Matthaei3, Steffen Manekeller3, Jörg C Kalff3, Christian P Strassburg1, Tobias J Weismüller1.   

Abstract

BACKGROUND: Chemotherapy with gemcitabine and cisplatin is the current standard for patients with unresectable cholangiocarcinoma. Local photodynamic therapy has also demonstrated benefit in patients with extrahepatic cholangiocarcinoma. AIM: To evaluate the benefit of photodynamic therapy in combination with systemic chemotherapy in advanced extrahepatic cholangiocarcinoma.
METHODS: Three hundred and fifty-three patients diagnosed with cholangiocarcinoma between 2004 and 2016 were treated at the University Hospital of Bonn, Germany. Of these, 96 suffering from unresectable extrahepatic cholangiocarcinoma were included. Patients were stratified according to treatment: combination photodynamic therapy and chemotherapy (36 patients), photodynamic therapy alone (34 patients), and chemotherapy alone (26 patients).
RESULTS: Combined photodynamic therapy with chemotherapy resulted in significantly longer overall survival than chemotherapy alone (P = 0.022). Median survival was 20 months in the combination group (95% CI: 16.38-23.62), 15 months in the photodynamic alone group (95% CI: 10.02-19.98) and 10 months in the chemotherapy alone group (95% CI: 8.45-11.55). In multivariate analysis, combination therapy and photodynamic therapy alone (HR: 0.41, 95% CI: 0.22-0.77, P = 0.006), metal stenting, and radiofrequency ablation were independent predictors of longer survival.
CONCLUSIONS: Combination photodynamic therapy and chemotherapy was well tolerated and resulted in significantly longer survival than chemotherapy alone. Application of photodynamic therapy significantly correlated with longer survival, demonstrating benefit in advanced cholangiocarcinoma. Thus, photodynamic therapy should be considered during therapeutic decision making in advanced cholangiocarcinoma.
© 2019 John Wiley & Sons Ltd.

Entities:  

Year:  2019        PMID: 30637783     DOI: 10.1111/apt.15050

Source DB:  PubMed          Journal:  Aliment Pharmacol Ther        ISSN: 0269-2813            Impact factor:   8.171


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