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Combined photodynamic therapy with systemic chemotherapy for unresectable cholangiocarcinoma
Author(s) -
GonzalezCarmona Maria Angeles,
Bolch Maximilian,
Jansen Christian,
Vogt Annabelle,
Sampels Matthias,
Mohr Raphael U.,
van Beekum Katrin,
Mahn Robert,
Praktiknjo Michael,
Nattermann Jacob,
Trebicka Jonel,
Branchi Vittorio,
Matthaei Hanno,
Manekeller Steffen,
Kalff Jörg C.,
Strassburg Christian P.,
Weismüller Tobias J.
Publication year - 2019
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.15050
Subject(s) - medicine , photodynamic therapy , gemcitabine , chemotherapy , oncology , combination therapy , gastroenterology , chemistry , organic chemistry
Summary 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.