Neoadjuvant Down-Sizing of Hilar Cholangiocarcinoma with Photodynamic Therapy—Long-Term Outcome of a Phase II Pilot Study †

International Journal of Molecular Sciences

Andrej Wagner³  Marcus Wiedmann²  Andrea Tannapfel⁴  Christian Mayr³  Tobias Kiesslich³  Gernot W. Wolkersdörfer³  Frieder Berr³  Johann Hauss⁶  Helmut Witzigmann¹  Michael R. Hamblin⁵ 

[1] Department for General and Visceral Surgery, Städtisches Krankenhaus Dresden-Friedrichstadt, Friedrichstraße 41, 01067 Dresden, Germany;Department of Internal Medicine I, St. Mary’s Hospital, Gallwitzallee 123-143, 12249 Berlin, Germany;Department of Medicine I, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Muellner Hauptstrasse 48, 5020 Salzburg, Austria;Institute of Pathology, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany;;Department of Medicine I, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Muellner Hauptstrasse 48, 5020 Salzburg, AustriaSecond Department of Surgery, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany;

关键词: bile duct cancer;    PDT;    sodium porfimer;    neoadjuvant therapy;   

DOI  :  10.3390/ijms161125978

来源: mdpi

【 摘 要 】

Hilar cholangiocarcinoma (CC) is non-resectable in the majority of patients often due to intrahepatic extension along bile duct branches/segments, and even after complete resection (R0) recurrence can be as high as 70%. Photodynamic therapy (PDT) is an established palliative local tumor ablative treatment for non-resectable hilar CC. We report the long-term outcome of curative resection (R0) performed after neoadjuvant PDT for downsizing of tumor margins in seven patients (median age 59 years) with initially non-resectable hilar CC. Photofrin^® was injected intravenously 24–48 h before laser light irradiation of the tumor stenoses and the adjacent bile duct segments. Major resective surgery was done with curative intention six weeks after PDT. All seven patients had been curatively (R0) resected and there were no undue early or late complications for the neoadjuvant PDT and surgery. Six of seven patients died from tumor recurrence at a median of 3.2 years after resection, the five-year survival rate was 43%. These results are comparable with published data for patients resected R0 without pre-treatment, indicating that neoadjuvant PDT is feasible and could improve overall survival of patients considered non-curatively resectable because of initial tumor extension in bile duct branches/segments—however, this concept needs to be validated in a larger trial.

【 授权许可】

CC BY   
© 2015 by the authors; licensee MDPI, Basel, Switzerland.