Abstract |
Photodynamic therapy ( PDT) has been established for palliation of non-resectable hilar bile duct cancer (hBDC). Ablation of hBDC using porfimer (P- PDT) improves cholestasis and survival. However, the tumoricidal effect is confined to the inner 4 mm of the tumor wall. Here, we have studied whether temoporfin PDT (T- PDT) shows an efficient local response and an increased tumoricidal penetration depth. In the first stage of a phase-II trial (NCT01016002), eleven patients with hBDC ( Bismuth III-IV) were treated with T- PDT plus stenting and 10 could be analyzed for local tumor response. T- PDT resulted in complete local response in n = 1 of 10 patients, partial response in n = 8 and no response in one patient (occluded right hepatic duct re-opened but positive for residual tumor cells) - indicating a tumoricidal efficacy of 90%. Four patients showed a tumoricidal depth of ≥7.5 mm. Cholestasis and palliation improved in 8 patients with an overall median survival of 18 (4.4-32.0) months after the first T- PDT. Adverse events were phototoxic skin reaction (n = 4), cholangitis (n = 3), and liver abscess (n = 3). T- PDT doubles the depth of the local tumor-ablative effect of P- PDT, is highly tumoricidal and is associated with similar rates of infectious complications and grade I and II skin phototoxicity.
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Authors | Andrej Wagner, Tobias Kiesslich, Daniel Neureiter, Paul Friesenbichler, Andreas Puespoek, Ulrike W Denzer, Gernot W Wolkersdörfer, Klaus Emmanuel, Ansgar W Lohse, Frieder Berr |
Journal | Photochemical & photobiological sciences : Official journal of the European Photochemistry Association and the European Society for Photobiology
(Photochem Photobiol Sci)
Vol. 12
Issue 6
Pg. 1065-73
(Jun 2013)
ISSN: 1474-9092 [Electronic] England |
PMID | 23558738
(Publication Type: Clinical Trial, Phase II, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antineoplastic Agents
- Mesoporphyrins
- Photosensitizing Agents
- temoporfin
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Topics |
- Aged
- Aged, 80 and over
- Antineoplastic Agents
(therapeutic use)
- Bile Duct Neoplasms
(drug therapy, pathology)
- Bile Ducts
(drug effects, pathology)
- Female
- Humans
- Male
- Mesoporphyrins
(therapeutic use)
- Middle Aged
- Photochemotherapy
(adverse effects)
- Photosensitizing Agents
(therapeutic use)
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