Application of photodynamic therapy in palliative treatment of unresectable hilar cholangiocarcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YAN Xuanxuan ^1,2 , LI Duofu ¹ ,  LI Xun ^1,2,3

1. The First Clinical Medicine School of Lanzhou University, Lanzhou 730000, P. R. China;
2. The Fifth Department of General Surgery, The First Hospital Affiliated to Lanzhou University, Lanzhou 730000, P. R. China;
3. Key Laboratory of Biotherapy and Regenerative Medicine in Gansu, Lanzhou 730000, P. R. China;

Corresponding?author：

LI Xun, Email: lxdr21@126.com

Keywords：

hilar cholangiocarcinoma; unresection; photodynamic therapy

DOI：

10.7507/1007-9424.201708068

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Objective To explore application value of photodynamic therapy (PDT) in treatment of unresectable hilar cholangiocarcinoma. Method The literatures about PDT in the treatment of the unresectable hilar cholangiocarcinoma in the PubMed, MedLine, Embase, CNKI, and Wanfang databases were reviewed. Results The PDT combined with stent or chemotherapy was the main method in the treatment of the unresectable hilar cholangiocarcinoma, which could make the tumor down-staging, obviously reduce the jaundice, improve the quality of life, improve the survival rate, prolong the stent patency and be treated repeatedly. Especially, it was suitable for the patients with elderly, poor health, intolerance of surgery, could partly replace the R1 or R2 operation of hilar cholangiocarcinoma and avoid the risk of surgery and postoperative complications. The therapeutic effective of the PDT was related to the early therapy and times of therapy. However, the shortcomes of the PDT were that the depth of killing tumor was not enough and there was a certain incidence of adverse reaction. Conclusions Therapeutic effect of PDT combine with stent or chemotherapy for unresectable hilar cholangiocarcinoma is better than that of single therapy. It is expected to be a first-line scheme of palliative treatment for unresectable hilar cholangiocarcinoma.

Citation： YAN Xuanxuan, LI Duofu, LI Xun. Application of photodynamic therapy in palliative treatment of unresectable hilar cholangiocarcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(4): 488-492. doi: 10.7507/1007-9424.201708068 Copy

1.	Ghouri YA, Mian I, Blechacz B. Cancer review: Cholangiocarcinoma. J Carcinog, 2015, 14: 1.
2.	Rerknimitr R, Angsuwatcharakon P, Ratanachu-ek T, et al. Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma. J Gastroenterol Hepatol, 2013, 28(4): 593-607.
3.	Goenka MK, Goenka U. Palliation: Hilar cholangiocarcinoma. World J Hepatol, 2014, 6(8): 559-569.
4.	Weiss MJ, Cosgrove D, Herman JM, et al. Multimodal treatment strategies for advanced hilar cholangiocarcinoma. Langenbecks Arch Surg, 2014, 399(6): 679-692.
5.	張憲祥, 盧云, 馮玉杰, 等. 肝門部膽管癌外科治療及療效. 中華肝臟外科手術學電子雜志, 2015, 4(2): 19-22.
6.	Geng ZM, Noor H, Zheng JB, et al. Advances in diagnosis and treatment of hilar cholangiocarcinoma—a review. Med Sci Monit, 2013, 19: 648-656.
7.	李志原, 李小祺, 崔培元. 不可切除肝門膽管癌的光動力學治療現狀. 中國腫瘤臨床, 2016, 43(16): 735-738.
8.	陳勇, 李婉婉, 周江蛟, 等. 光動力療法分子機制研究進展. 中南大學學報(醫學版), 2014, 39(1): 102-108.
9.	Zhao L, Kim TH, Kim HW, et al. Enhanced cellular uptake and phototoxicity of verteporfin-conjugated gold nanoparticles as theranostic nanocarriers for targeted photodynamic therapy and imaging of cancers. Mater Sci Eng C Mater Biol Appl, 2016, 67: 611-622.
10.	Kessel D, Oleinick NL. Cell death pathways associated with photodynamic therapy: an update. Photochem Photobiol, 2017 Nov 16. doi: 10.1111/php.12857.
11.	Almeida RD, Manadas BJ, Carvalho AP, et al. Intracellular signaling mechanisms in photodynamic therapy. Biochim Biophys Acta, 2004, 1704(2): 59-86.
12.	Wachowska M, Muchowicz A, Demkow U. Immunological aspects of antitumor photodynamic therapy outcome. Cent Eur J Immunol, 2015, 40(4): 481-485.
13.	Cheon YK, Lee TY, Lee SM, et al. Longterm outcome of photodynamic therapy compared with biliary stenting alone in patients with advanced hilar cholangiocarcinoma. HPB (Oxford), 2012, 14(3): 185-193.
14.	Witzigmann H, Berr F, Ringel U, et al. Surgical and palliative management and outcome in 184 patients with hilar cholangiocarcinoma: palliative photodynamic therapy plus stenting is comparable to R1/R2 resection. Ann Surg, 2006, 244(2): 230-239.
15.	Matull WR, Dhar DK, Ayaru L, et al. R0 but not R1/R2 resection is associated with better survival than palliative photodynamic therapy in biliary tract cancer. Liver Int, 2011, 31(1): 99-107.
16.	Lee TY, Cheon YK, Shim CS, et al. Photodynamic therapy prolongs metal stent patency in patients with unresectable hilar cholangiocarcinoma. World J Gastroenterol, 2012, 18(39): 5589-5594.
17.	Kahaleh M, Mishra R, Shami VM, et al. Unresectable cholangiocarcinoma: comparison of survival in biliary stenting alone versus stenting with photodynamic therapy. Clin Gastroenterol Hepatol, 2008, 6(3): 290-297.
18.	Quyn AJ, Ziyaie D, Polignano FM, et al. Photodynamic therapy is associated with an improvement in survival in patients with irresectable hilar cholangiocarcinoma. HPB (Oxford), 2009, 11(7): 570-577.
19.	Strand DS, Cosgrove ND, Patrie JT, et al. ERCP-directed radiofrequency ablation and photodynamic therapy are associated with comparable survival in the treatment of unresectable cholangiocarcinoma. Gastrointest Endosc, 2014, 80(5): 794-804.
20.	Shimizu S, Nakazawa T, Hayashi K, et al. Photodynamic Therapy using Talaporfin Sodium for the Recurrence of Cholangiocarcinoma after Surgical Resection. Intern Med, 2015, 54(18): 2321-2326.
21.	胡驍, 胡維昱, 孫傳東, 等. 肝門部膽管癌根治性切除術后并發癥的診斷與治療. 中華肝臟外科手術學電子雜志, 2015, 4(4): 206-209.
22.	Weijer R, Broekgaarden M, van Golen RF, et al. Low-power photodynamic therapy induces survival signaling in perihilar cholangiocarcinoma cells. BMC Cancer, 2015, 15: 1014.
23.	Wagner A, Wiedmann M, Tannapfel A, et al. Neoadjuvant down-sizing of hilar cholangiocarcinoma with photodynamic therapy—long-term outcome of a phase Ⅱ pilot study. Int J Mol Sci, 2015, 16(11): 26619-26628.
24.	Wiedmann M, Caca K, Berr F, et al. Neoadjuvant photodynamic therapy as a new approach to treating hilar cholangiocarcinoma: a phase Ⅱ pilot study. Cancer, 2003, 97(11): 2783-2790.
25.	Prasad GA, Wang KK, Baron TH, et al. Factors associated with increased survival after photodynamic therapy for cholangiocarcinoma. Clin Gastroenterol Hepatol, 2007, 5(6): 743-748.
26.	Dolak W, Schwaighofer H, Hellmich B, et al. Photodynamic therapy with polyhematoporphyrin for malignant biliary obstruction: A nationwide retrospective study of 150 consecutive applications. United European Gastroenterol J, 2017, 5(1): 104-110.
27.	Hong MJ, Cheon YK, Lee EJ, et al. Long-term outcome of photodynamic therapy with systemic chemotherapy compared to photodynamic therapy alone in patients with advanced hilar cholangiocarcinoma. Gut Liver, 2014, 8(3): 318-323.
28.	Shim CS, Cheon YK, Cha SW, et al. Prospective study of the effectiveness of percutaneous transhepatic photodynamic therapy for advanced bile duct cancer and the role of intraductal ultrasonography in response assessment. Endoscopy, 2005, 37(5): 425.
29.	Lee TY, Cheon YK, Shim CS. Photodynamic therapy in patients with advanced hilar cholangiocarcinoma: percutaneous cholangioscopic versus peroral transpapillary approach. Photomed Laser Surg, 2016, 34(4): 150-156.
30.	余繼海, 邱陸軍, 馬金良, 等. 影響非手術治療肝門部膽管癌預后因素分析. 肝膽外科雜志, 2008, 16(4): 281-283.
31.	Wentrup R, Winkelmann N, Mitroshkin A, et al. Photodynamic therapy plus chemotherapy compared with photodynamic therapy alone in hilar nonresectable cholangiocarcinoma.Gut Liver, 2016, 10(3): 470-475.
32.	Park DH, Lee SS, Park SE, et al. Randomised phase Ⅱ trial of photodynamic therapy plus oral fluoropyrimidine, S-1, versus photodynamic therapy alone for unresectable hilar cholangiocarcinoma. Eur J Cancer, 2014, 50(7): 1259-1268.
33.	Zoepf T, Jakobs R, Arnold JC, et al. Palliation of nonresectable bile duct cancer: improved survival after photodynamic therapy. Am J Gastroenterol, 2005, 100(11): 2426-2430.
34.	Lee IS, Wang H, Chae Y, et al. Functional neuroimaging studies in functional dyspepsia patients: a systematic review. Neurogastroenterol Motil, 2016, 28(6): 793-805.
35.	Patel J, Rizk N, Kahaleh M. Role of photodynamic therapy and intraductal radiofrequency ablation in cholangiocarcinoma. Best Pract Res Clin Gastroenterol, 2015, 29(2): 309-318.
36.	Nanashima A, Nagayasu T. Current status of photodynamic therapy in digestive tract carcinoma in Japan. Int J Mol Sci, 2015, 16(2): 3434-3440.
37.	Pereira SP, Aithal GP, Ragunath K, et al. Safety and long term efficacy of porfimer sodium photodynamic therapy in locally advanced biliary tract carcinoma. Photodiagnosis Photodyn Ther, 2012, 9(4): 287-292.
38.	Smith I, Kahaleh M. Biliary tumor ablation with photodynamic therapy and radiofrequency ablation. Gastrointest Endosc Clin N Am, 2015, 25(4): 793-804.
39.	汪昕, 鄭建偉, 鄒聲泉. 光動力療法在抗腫瘤血管方面的應用. 臨床外科雜志, 2007, 15(4): 277-278.

1. Ghouri YA, Mian I, Blechacz B. Cancer review: Cholangiocarcinoma. J Carcinog, 2015, 14: 1.
2. Rerknimitr R, Angsuwatcharakon P, Ratanachu-ek T, et al. Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma. J Gastroenterol Hepatol, 2013, 28(4): 593-607.
3. Goenka MK, Goenka U. Palliation: Hilar cholangiocarcinoma. World J Hepatol, 2014, 6(8): 559-569.
4. Weiss MJ, Cosgrove D, Herman JM, et al. Multimodal treatment strategies for advanced hilar cholangiocarcinoma. Langenbecks Arch Surg, 2014, 399(6): 679-692.
5. 張憲祥, 盧云, 馮玉杰, 等. 肝門部膽管癌外科治療及療效. 中華肝臟外科手術學電子雜志, 2015, 4(2): 19-22.
6. Geng ZM, Noor H, Zheng JB, et al. Advances in diagnosis and treatment of hilar cholangiocarcinoma—a review. Med Sci Monit, 2013, 19: 648-656.
7. 李志原, 李小祺, 崔培元. 不可切除肝門膽管癌的光動力學治療現狀. 中國腫瘤臨床, 2016, 43(16): 735-738.
8. 陳勇, 李婉婉, 周江蛟, 等. 光動力療法分子機制研究進展. 中南大學學報(醫學版), 2014, 39(1): 102-108.
9. Zhao L, Kim TH, Kim HW, et al. Enhanced cellular uptake and phototoxicity of verteporfin-conjugated gold nanoparticles as theranostic nanocarriers for targeted photodynamic therapy and imaging of cancers. Mater Sci Eng C Mater Biol Appl, 2016, 67: 611-622.
10. Kessel D, Oleinick NL. Cell death pathways associated with photodynamic therapy: an update. Photochem Photobiol, 2017 Nov 16. doi: 10.1111/php.12857.
11. Almeida RD, Manadas BJ, Carvalho AP, et al. Intracellular signaling mechanisms in photodynamic therapy. Biochim Biophys Acta, 2004, 1704(2): 59-86.
12. Wachowska M, Muchowicz A, Demkow U. Immunological aspects of antitumor photodynamic therapy outcome. Cent Eur J Immunol, 2015, 40(4): 481-485.
13. Cheon YK, Lee TY, Lee SM, et al. Longterm outcome of photodynamic therapy compared with biliary stenting alone in patients with advanced hilar cholangiocarcinoma. HPB (Oxford), 2012, 14(3): 185-193.
14. Witzigmann H, Berr F, Ringel U, et al. Surgical and palliative management and outcome in 184 patients with hilar cholangiocarcinoma: palliative photodynamic therapy plus stenting is comparable to R1/R2 resection. Ann Surg, 2006, 244(2): 230-239.
15. Matull WR, Dhar DK, Ayaru L, et al. R0 but not R1/R2 resection is associated with better survival than palliative photodynamic therapy in biliary tract cancer. Liver Int, 2011, 31(1): 99-107.
16. Lee TY, Cheon YK, Shim CS, et al. Photodynamic therapy prolongs metal stent patency in patients with unresectable hilar cholangiocarcinoma. World J Gastroenterol, 2012, 18(39): 5589-5594.
17. Kahaleh M, Mishra R, Shami VM, et al. Unresectable cholangiocarcinoma: comparison of survival in biliary stenting alone versus stenting with photodynamic therapy. Clin Gastroenterol Hepatol, 2008, 6(3): 290-297.
18. Quyn AJ, Ziyaie D, Polignano FM, et al. Photodynamic therapy is associated with an improvement in survival in patients with irresectable hilar cholangiocarcinoma. HPB (Oxford), 2009, 11(7): 570-577.
19. Strand DS, Cosgrove ND, Patrie JT, et al. ERCP-directed radiofrequency ablation and photodynamic therapy are associated with comparable survival in the treatment of unresectable cholangiocarcinoma. Gastrointest Endosc, 2014, 80(5): 794-804.
20. Shimizu S, Nakazawa T, Hayashi K, et al. Photodynamic Therapy using Talaporfin Sodium for the Recurrence of Cholangiocarcinoma after Surgical Resection. Intern Med, 2015, 54(18): 2321-2326.
21. 胡驍, 胡維昱, 孫傳東, 等. 肝門部膽管癌根治性切除術后并發癥的診斷與治療. 中華肝臟外科手術學電子雜志, 2015, 4(4): 206-209.
22. Weijer R, Broekgaarden M, van Golen RF, et al. Low-power photodynamic therapy induces survival signaling in perihilar cholangiocarcinoma cells. BMC Cancer, 2015, 15: 1014.
23. Wagner A, Wiedmann M, Tannapfel A, et al. Neoadjuvant down-sizing of hilar cholangiocarcinoma with photodynamic therapy—long-term outcome of a phase Ⅱ pilot study. Int J Mol Sci, 2015, 16(11): 26619-26628.
24. Wiedmann M, Caca K, Berr F, et al. Neoadjuvant photodynamic therapy as a new approach to treating hilar cholangiocarcinoma: a phase Ⅱ pilot study. Cancer, 2003, 97(11): 2783-2790.
25. Prasad GA, Wang KK, Baron TH, et al. Factors associated with increased survival after photodynamic therapy for cholangiocarcinoma. Clin Gastroenterol Hepatol, 2007, 5(6): 743-748.
26. Dolak W, Schwaighofer H, Hellmich B, et al. Photodynamic therapy with polyhematoporphyrin for malignant biliary obstruction: A nationwide retrospective study of 150 consecutive applications. United European Gastroenterol J, 2017, 5(1): 104-110.
27. Hong MJ, Cheon YK, Lee EJ, et al. Long-term outcome of photodynamic therapy with systemic chemotherapy compared to photodynamic therapy alone in patients with advanced hilar cholangiocarcinoma. Gut Liver, 2014, 8(3): 318-323.
28. Shim CS, Cheon YK, Cha SW, et al. Prospective study of the effectiveness of percutaneous transhepatic photodynamic therapy for advanced bile duct cancer and the role of intraductal ultrasonography in response assessment. Endoscopy, 2005, 37(5): 425.
29. Lee TY, Cheon YK, Shim CS. Photodynamic therapy in patients with advanced hilar cholangiocarcinoma: percutaneous cholangioscopic versus peroral transpapillary approach. Photomed Laser Surg, 2016, 34(4): 150-156.
30. 余繼海, 邱陸軍, 馬金良, 等. 影響非手術治療肝門部膽管癌預后因素分析. 肝膽外科雜志, 2008, 16(4): 281-283.
31. Wentrup R, Winkelmann N, Mitroshkin A, et al. Photodynamic therapy plus chemotherapy compared with photodynamic therapy alone in hilar nonresectable cholangiocarcinoma.Gut Liver, 2016, 10(3): 470-475.
32. Park DH, Lee SS, Park SE, et al. Randomised phase Ⅱ trial of photodynamic therapy plus oral fluoropyrimidine, S-1, versus photodynamic therapy alone for unresectable hilar cholangiocarcinoma. Eur J Cancer, 2014, 50(7): 1259-1268.
33. Zoepf T, Jakobs R, Arnold JC, et al. Palliation of nonresectable bile duct cancer: improved survival after photodynamic therapy. Am J Gastroenterol, 2005, 100(11): 2426-2430.
34. Lee IS, Wang H, Chae Y, et al. Functional neuroimaging studies in functional dyspepsia patients: a systematic review. Neurogastroenterol Motil, 2016, 28(6): 793-805.
35. Patel J, Rizk N, Kahaleh M. Role of photodynamic therapy and intraductal radiofrequency ablation in cholangiocarcinoma. Best Pract Res Clin Gastroenterol, 2015, 29(2): 309-318.
36. Nanashima A, Nagayasu T. Current status of photodynamic therapy in digestive tract carcinoma in Japan. Int J Mol Sci, 2015, 16(2): 3434-3440.
37. Pereira SP, Aithal GP, Ragunath K, et al. Safety and long term efficacy of porfimer sodium photodynamic therapy in locally advanced biliary tract carcinoma. Photodiagnosis Photodyn Ther, 2012, 9(4): 287-292.
38. Smith I, Kahaleh M. Biliary tumor ablation with photodynamic therapy and radiofrequency ablation. Gastrointest Endosc Clin N Am, 2015, 25(4): 793-804.
39. 汪昕, 鄭建偉, 鄒聲泉. 光動力療法在抗腫瘤血管方面的應用. 臨床外科雜志, 2007, 15(4): 277-278.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of photodynamic therapy in palliative treatment of unresectable hilar cholangiocarcinoma

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