title: Treatment of unresectable extrahepatic cholangiocarcinoma using hematoporphyrin photodynamic therapy: A prospective study.
abstract: BACKGROUND
  The available evidence of Photodynamic therapy (PDT) combined with stent placement treatment for unresectable extrahepatic cholangiocarcinoma (EHCC) is still insufficient. It also remains unclear whether PDT influences systemic inflammatory response.
  
  
  OBJECTIVE
  To explore the clinical efficacy and safety of the combination treatment and the systemic inflammatory response in patients with EHCC.
  
  
  METHODS
  Patients with unresectable EHCC underwent either the combined treatment using Hematoporphyrin PDT and stent placement (PDT+stent group, n=12) or stent-only (stent group, n=27). The primary end-point was overall survival. Tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels were measured. Quality of life was assessed using the Karnofsky performance scale (KPS) every 3 months.
  
  
  RESULTS
  Average survival time (13.8 vs. 9.6 months), and 6-month (91.7% vs. 74.1%), and 1-year (58.3% vs. 3.7%) survival rates of PDT+stent group were significantly increased compared with the stent group. KPS scores in the PDT+stent group were significantly improved. TNF-α and IL-6 levels were significantly increased in the PDT+stent group.
  
  
  CONCLUSIONS
  Hematoporphyrin-PDT combined with stent placement is an effective and safe treatment for EHCC. The treatment might promote systemic inflammatory response.
authors.affiliation: Department of Gastroenterology, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, Zhejiang Province, China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Gastroenterology, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, Zhejiang Province, China.
authors.forename: Hongzhang
authors.initials: H
authors.lastname: Shen
authors.affiliation: Department of Gastroenterology, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, Zhejiang Province, China.
authors.forename: Hangbin
authors.initials: H
authors.lastname: Jin
authors.affiliation: Department of Gastroenterology, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, Zhejiang Province, China.
authors.forename: Qifeng
authors.initials: Q
authors.lastname: Lou
authors.affiliation: Department of Gastroenterology, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, Zhejiang Province, China. Electronic address: zxf837@126.com.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000276:immunology / Q000401:mortality* / Q000628:therapy*; D002681:China / Q000453:epidemiology; D018281:Cholangiocarcinoma / Q000276:immunology / Q000401:mortality* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006415:Hematoporphyrins / Q000627:therapeutic use; D006801:Humans; D007565:Jaundice / Q000276:immunology / Q000401:mortality / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000401:mortality* / Q000706:statistics & numerical data; D017319:Photosensitizing Agents / Q000627:therapeutic use; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D006415:Hematoporphyrins; D017319:Photosensitizing Agents
keywords: Cholangiocarcinoma; Efficacy; Intraductal ultrasonography; Photodynamic therapy; Safety; Systemic inflammatory response