Treatment of unresectable extrahepatic cholangiocarcinoma using hematoporphyrin photodynamic therapy: A prospective study

Background: The available evidence of Photodynamic therapy (PDT) combined with stent placement treatment for unresectable extrahepatic cholangiocarcinoma (EHCC) is still insufficient. It also remains unclear whether PDT influences systemic inflammatory response. Aim: To explore the clinical efficacy and safety of the combination treatment and the systemic inflammatory response in patients with EHCC. Methods: Patients with unresectable EHCC underwent either the combined treatment using Hematoporphyrin PDT and stent placement (PDT + stent group, n = 12) or stent-only (stent group, n = 27). The primary end-point was overall survival. Tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 levels were measured. Quality of life was assessed using the Karnofsky performance scale (KPS) every 3 months. Results: Average survival time (13.8 vs. 9.6 months), and 6-month (91.7% vs. 74.1%), and 1-year (58.3% vs. 3.7%) survival rates of PDT + stent group were significantly increased compared with the stent group. KPS scores in the PDT + stent group were significantly improved. TNF-alpha and IL-6 levels were significantly increased in the PDT + stent group. Conclusion: Hematoporphyrin-PDT combined with stent placement is an effective and safe treatment for EHCC. The treatment might promote systemic inflammatory response. (C) 2016 Elsevier B.V. All rights reserved.