The efficacy of adjuvant
photodynamic therapy (
PDT) using the new
photosensitizer,
talaporfin sodium (TPS) has been clinically examined in some patients with bile duct
carcinoma (BDC). Based on our previous cohorts, a prospective clinical trial was attempted; however, only two cases were ultimately enrolled in 27 months. A 664-nm
semiconductor laser (100 J/cm2) was applied through an
endoscope to the
tumor lesion within 6 h of an
intravenous injection of 40 mg/m2 TPS according to the protocol for
lung cancer. Case 1 was an 82-y.o. female patient with BDC at the left hepatic duct with biliary obstruction, percutaneous transhepatic biliary drainage (
PTBD) was achieved, and the patient did not consent to surgery. She was followed up for 15 months to search for non-surgical treatments and eventually received
PDT. Although mild photosensitivity occurred, she was discharged without severe adverse events. Biliary
stenosis markedly extended and a
PTBD tube was scheduled at 1 month. However,
cancer immediately metastasized to the liver and she died 155 days after
PDT. Case 2 was a 70-y.o. female with perihilar BDC and multiple biliary
stenoses. Multiple biliary stenting was considered to be difficult. She received
PDT and no adverse events were observed. Biliary
stenoses markedly improved and multiple stenting was successfully performed. On day 132, she died of
cancer progression. These two cases demonstrated the safety and efficacy of biliary malignant
stenosis soon after
PDT; however, long-term survival and a sufficient quality of life were not achieved. The combination of the
PDT protocol and system
chemotherapy or
brachytherapy needs to be examined in clinical trials for advanced stage BDC.