title: Advances in photodynamic therapy for the treatment of hilar biliary tract cancer.
abstract: The prognosis of patients with nonresectable hilar biliary tract cancer (hBTC) is poor. Responsiveness to chemotherapy or radiochemotherapy is moderate at best, and patients are at a high risk of dying early from complications of local tumor infiltration (e.g., cholestasis, septic cholangitis, empyema or liver failure) rather than systemic disease. Therefore, palliative local therapy for the prevention of tumor complications plays a central role and still yields the longest survival times. Photodynamic therapy (PDT) is a local-ablative, tumor tissue-specific treatment currently representing the standard of care for nonresectable hBTC. Throughout the literature, PDT plus biliary drainage achieves median survival times in the range of 9-21 months (average 14-16 months), compared with approximately 6 months for drainage only. This article summarizes the recent advances in preclinical and clinical experience of PDT for hBTC, including experimental in vitro and in vivo studies, clinical studies and an overview of the ongoing clinical trials.
authors.affiliation: Department of Internal Medicine, Paracelsus Medical University, Salzburger Landeskliniken (SALK), Muellner Hauptstrasse 48, Salzburg, Austria.
authors.forename: Tobias
authors.initials: T
authors.lastname: Kiesslich
authors.forename: Daniel
authors.initials: D
authors.lastname: Neureiter
authors.forename: Gernot W
authors.initials: GW
authors.lastname: Wolkersdörfer
authors.forename: Kristjan
authors.initials: K
authors.lastname: Plaetzer
authors.forename: Frieder
authors.initials: F
authors.lastname: Berr
mesh_terms: D000818:Animals; D024221:Antineoplastic Protocols; D001661:Biliary Tract Neoplasms / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004353:Drug Evaluation, Preclinical; D006801:Humans; D058990:Molecular Targeted Therapy; D010166:Palliative Care; D010778:Photochemotherapy / Q000379:methods*