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Photodynamic therapy, stents increase survival for extrahepatic cholangiocarcinoma

The use of photodynamic therapy with stents was safe and increased survival among patients with unresectable extrahepatic cholangiocarcinoma vs. stents alone, per results from a retrospective study presented at UEG Week 2016.

In the study, Jianfeng Yang, MD, department of gastroenterology, Hangzhou First People’s Hospital, China, and colleagues assigned patients with unresectable extrahepatic cholangiocarcinoma to a treatment regimen of either photodynamic therapy (PDT) plus stent placement (n = 12) or stent-only treatment (n = 27). Intraductal ultrasonography was used to measure thickness of tumor mass and quality of life was assessed using Karnofsky performance scale scores every 3 months.

“Photodynamic therapy combined with stent placement is considered an effective palliative treatment for unresectable extrahepatic cholangiocarcinoma,” Yang and colleagues wrote. “However, the available evidence is still insufficient and not yet strong enough for prospective, controlled study results reported infrequently. …It remains unclear whether PTD plays a role in promoting a systemic inflammatory response in patients with [extrahepatic cholangiocarcinoma].”
Analysis results showed the average survival time was higher among patients who received treatment with PDT plus stents (13.8 months) compared with patients who used stents only (9.6 months; P < .001). The survival time was also greater among patients who used both PDT and stents at 6 months (91.7% vs. 74.1%; P < .001) and 1 year (58.3% vs. 3.7%; P < .001) compared with the stent group.

Quality of life at 1, 3 and 6 months postoperative was higher in patients who underwent PDT with stents compared with the stent-only group (P < .05). In addition, tumor necrosis factor-α and interleukin-6 levels were higher in patients who underwent PDT with stents compared with the stent-only group 1 week postoperative (P < .05).

The mean thickness of tumor mass was significantly lower in patients who underwent PDT with stents after 1 postoperative month (P = .02) and 3 postoperative months (P = .04).

The rate of postoperative adverse events was not significantly different between the two groups (16.7% vs. 22.2%), per the abstract.

The optimal time interval between PDT is 4 to 6 months, the researchers wrote. They further mentioned that PDT may cause systemic inflammation in patients with extrahepatic cholangiocarcinoma and have a direct destructive effect on cancer tissue.

They concluded: “PDT combined with stent placement is an effective, safe treatment for [extrahepatic cholangiocarcinoma] can significantly improve alleviation of jaundice, prolong survival time, and improve quality of life, while not increasing the incidence of adverse events.” – by Melinda Stevens

Reference:

Yang J, et al. Presented at: United European Gastroenterology Week; Oct. 15-19, 2016; Vienna.

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