Presence and Future of the Advanced Photodynamic Therapy in Bile Duct Carcinomas

Abstract

The effective local controls influence the patient survival in the bile duct carcinomas (BDC). In the non-resectable BDC, reliable non-surgical modality is expected and photodynamic therapy (PDT) is a useful option. PDT is a cancer-specific treatment radiated by a specific wave length of laser beam to the injected photosensitizer specifically accumulating in cancer cells. Weak point is a long-term photosensitivity by the applied photosensitizer for PDT. In the recent years, the new photosensitizer, which reduces period of light shield and its degree, has been developed only in the early stage lung cancers. We have started the basic research and clinical trial by using the new photosensitizer and the higher level of cytocidal effects or safety were shown in comparison with the previous PDT. We show these results and discuss a prospect of presence and future of PDT in BDC in the new era.

Photodynamic Therapy using Talaporfin Sodium for the Recurrence of Cholangiocarcinoma after Surgical Resection

“…According to the literature (12), patients undergoing PDT with porfimer sodium had a significantly longer admission period compared to patients undergoing PDT with talaporfin sodium (36 vs. 5 days, respectively; p<0.01). In the present case, the period of hospitalization was 14 days to avoid skin phototoxicity, however, this period was shorter than the reported period of PDT with porfimer sodium in the study by Nanashima et al (12). Therefore, the efficacy, safety, and period of hospitalization with PDT using talaporfin sodium in the present case were similar to those of their report (12).…”

“…In the present case, the period of hospitalization was 14 days to avoid skin phototoxicity, however, this period was shorter than the reported period of PDT with porfimer sodium in the study by Nanashima et al (12). Therefore, the efficacy, safety, and period of hospitalization with PDT using talaporfin sodium in the present case were similar to those of their report (12). Several additional devices are needed for the PDT cholangiocarcinoma irradiation procedure.…”

“…Adverse events, such as cholangitis, biloma, cholecystitis, pancreatitis, sepsis, and biliary leakage have also been reported, albeit rarely (16). Nanashima et al reported that photodermatitis, liver dysfunction, cholangitis, pancreatitis, and liver abscess were each observed in at least one patient following PDT with talaporfin sodium in their study, and no endoscopy-related ad-verse events were observed in any patients (12). Serious adverse events have not been reported, and PDT is a generally well-tolerated treatment.…”

“…The clinical usefulness and survival benefits of PDT for unresectable cholangiocarcinoma have been previously reported (1, 3-6), but the use of PDT for resectable cholangiocarcinoma as neoadjuvant or adjuvant therapy is the subject of several reports (9)(10)(11)(12). The depth of tumor necrosis caused by PDT depends on the photosensitizer and the activation at the optimal wavelength.…”