Intraductal Photodynamic Therapy of Hilar Cholangiocarcinoma in Inoperable Patients

B. I. Dolgushin; O. N. Sergeeva; D. Yu. Frantsev; A. V. Kukushkin; V. O. Panov; E. R. Virshke; V. Yu. Kosyrev; V. A. Cherkasov; I. A. Trofimov; O. V. Chistyakova; E. A. Moroz; I. V. Pogrebnyakov; N. A. Shishkina

doi:10.16931/1995-5464.20163106-118

Intraductal Photodynamic Therapy of Hilar Cholangiocarcinoma in Inoperable Patients

B. I. Dolgushin, O. N. Sergeeva, D. Yu. Frantsev, A. V. Kukushkin, V. O. Panov, E. R. Virshke, V. Yu. Kosyrev, V. A. Cherkasov, I. A. Trofimov, O. V. Chistyakova, E. A. Moroz, I. V. Pogrebnyakov, N. A. Shishkina

https://doi.org/10.16931/1995-5464.20163106-118

Park J., Kim M.H., Kim K.P., Park do H., Moon S.H., Song T.J., Eum J., Lee S.S., Seo D.W., Lee S.K. Natural history and prognostic factors of advanced cholangiocarcinoma without surgery, chemotherapy, or radiotherapy: A large-scale observational study. Gut Liver. 2009; 3 (4): 298–305. doi: 10.5009/gnl.2009.3.4.298. PMID: 20431764. Henderson B.W., Dougherty T.J. How does photodynamic therapy work? Photochem. Photobiol. 1992; 55 (1): 145–157. doi: 10.1111/j.1751-1097.1992.tb04222.x. PMID: 1603846. Dougherty T.J., Gomer C.J., Henderson B.W., Jori G., Kessel D., Korbelik M., Moan J., Peng Q. Photodynamic therapy. J. Natl. Cancer Inst. 1998; 90 (12): 889–905. doi: 10.1093/jnci/90.12.889. PMID: 9637138. McCaughan J.S. Jr., Mertens B.F., Cho C., Barabash R.D., Payton H.W. Photodynamic therapy to treat tumors of the extrahepatic biliary ducts. A case report. Arch. Surg. 1991; 126 (1): 111–113. doi: 10.1001/archsurg.1991.01410250119022. PMID: 1824676. Ortner M.E., Caca K., Berr F., Liebetruth J., Mansmann U., Huster D., Voderholzer W., Schachschal G., Mossner J.,Lochs H. Successful photodynamic therapy for nonresectable cholangiocarcinoma: a randomized prospective study. Gastroenterology. 2003; 125 (5): 1355–1363. PMID: 14598251. doi: http://dx.doi.org/10.1016/j.gastro.2003.07.015. Zoepf T., Jakobs R., Arnold J.C., Apel D., Riemann J.F. Palliation of nonresectable bile duct cancer: improved survival after photodynamic therapy. Am. J. Gastroenterol. 2005; 100 (11): 2426–2430. doi: 10.1111/j.1572-0241.2005.00318.x. PMID: 16279895. Quishida C.C., Mima E.G., Dovigo L.N., Jorge J.H., Bagnato V.S., Pavarina A.C. Photodynamic inactivation of a multispecies biofilm using Photodithazine(®) and LED light after one and three successive applications. Lasers Med. Sci. 2015; 30 (9): 2303–2312. doi: 10.1007/s10103-015-1811-9. PMID: 26404782. Juzeniene A., Kessel D., Korbelik M., Moan J., Mroz P., Nowis D., Piette J., Wilson B.C., Golab J. Photodynamic therapy of cancer: an update. CA Cancer J. Clin. 2011; 61 (4): 250–281. doi: 10.3322/caac.20114. PMID: 21617154. Bismuth H., Corlette M.B. Intrahepatic cholangioenteric anastomosis in carcinoma of the hilus of the liver. Surg. Gynaecol. Obstet. 1975; 140 (2): 170–178. PMID: 1079096. Sergeeva O.N., Dolgushin B.I., Panov V.O., Kukushkin A.V., Reshetnikov A.V. EOB-DTPA-enhanced MRI assessment of intraductal photodynamic therapy action in hilar cholangiocarcinoma patients. E-poster. The European Congress of Radiology. 2011, Vienna, Austria, 1–5 Mar 2011. doi: 10.1594/ecr2011/C-1059. Siva S., MacManus M.P., Martin R.F., Martin O.A. Abscopal effects of radiation therapy: a clinical review for the radiobiologist. Cancer Lett. 2015; 356 (1): 82–90. doi: 10.1016/j.canlet.2013.09.018. PMID: 24125863.

Full Text:

PDF (Rus)

Generate QR code

Abstract

Aim. To research the influence of intraductal photodynamic therapy (PDT) on the duration and life quality in patients with inoperable hilar cholangiocarcinoma.
Material and Methods. 39 patients aged 34–75 years with Klatskin tumor (Bismuth type IV) underwent one hundred and eighteen PDT procedures for the period 2008–2015. All patients had 1–4 percutaneous bile duct drains. The second generation of chlorin sensitizers were administrated intravenously two to four hours prior to the consecutive intraductal laser irradiation. Irradiation of affected ducts were performed using flexible optical fiber injected by original method under X-ray control. Laser irradiation was performed in a pulsed mode, the radiation dose was determined individually

depending on lesion severity. Diagnosis of tumors and dynamic control were performed using morphological examination, cholangiography and MRI.
Results. Follow-up was 2–47 months. There was no postoperative mortality. Three patients had post-procedural complications including liver abscess in one and gallbladder empyema in two cases that required minimally invasive interventions. The intraductal PDT reduced incidence of cholangitis exacerbation and improved quality of life. The median survival was 16 months (2–47), after the first PDT procedure and 31 months (5-69) after diagnosis. 1-, 2-,
3-, 4- and 5-year survival rates were 88%, 68%, 39%, 14,8% and 5% respectively.
Conclusion. Intraductal PDT is perspective to improve both survival rate and quality of life in inoperable patients

Keywords

liver, bile ducts, cancer of extrahepatic bile ducts, hilar cholangiocarcinoma, Klatskin tumor, cholangiostomy, photodynamic therapy, intraductal biopsy, X-ray endobiliary interventions

About the Authors

B. I. Dolgushin

Research Institute of Clinical and Experimental Radiology, Laboratory of Interventional Radiology
Russian Federation

Doct. of Med. Sci., Professor, Corresponding Member of the Russian Academy of Sciences, Head f the Research Institute of Clinical and Experimental Radiology, N.N. Blokhin Russian Cancer Research Centre, Ministry of Healthcare of the Russian Federation

O. N. Sergeeva

Research Institute of Clinical and Experimental Radiology, Laboratory of Interventional Radiology
Russian Federation

Cand. of Med. Sci., Photodynamic Therapy Group Leader,
Senior Researcher of Interventional Radiology Laboratory, Research Institute of Clinical and Experimental Radiology,
N.N. Blokhin Russian Cancer Research Centre, Ministry of Healthcare of the Russian Federation

D. Yu. Frantsev

Research Institute of Clinical and Experimental Radiology, Laboratory of Interventional Radiology
Russian Federation

Resident of Clinical and Experimental Radiology Research Institute, N.N. Blokhin Russian Cancer Research Centre, Ministry of Healthcare of the Russian Federation

A. V. Kukushkin

Research Institute of Clinical and Experimental Radiology, Laboratory of Interventional Radiology
Russian Federation

Cand. of Med. Sci., Physician of Interventional Radiology Laboratory, Clinical and Experimental Radiology Research Institute, N.N. Blokhin Russian Cancer Research Centre, Ministry of Healthcare of the Russian Federation

V. O. Panov

Research Institute of Clinical and Experimental Radiology, Radiology Department
Russian Federation

Cand. of Med. Sci., Leading Researcher of Radiology Department, Clinical and Experimental Radiology Research Institute, N.N. Blokhin Russian Cancer Research Centre, Ministry of Healthcare of the Russian Federation

E. R. Virshke

Research Institute of Clinical and Experimental Radiology, Laboratory of Interventional Radiology
Russian Federation

Doct. of Med. Sci., Chief of Interventional Radiology Laboratory Department, Clinical and Experimental Radiology Research Institute, N.N. Blokhin Russian Cancer Research Centre, Ministry of Healthcare of the Russian Federation

V. Yu. Kosyrev

Research Institute of Clinical and Experimental Radiology, Laboratory of Interventional Radiology
Russian Federation

Doct. of Med. Sci., Leading Researcher of Interventional Radiology Laboratory Department, Clinical and Experimental Radiology Research Institute, N.N. Blokhin Russian Cancer Research Centre, Ministry of Healthcare of the Russian Federation

V. A. Cherkasov

Research Institute of Clinical and Experimental Radiology, Laboratory of Interventional Radiology
Russian Federation

Cand. of Med. Sci., Senior Researcher of Interventional Radiology Laboratory, Clinical and Experimental Radiology Research Institute, N.N. Blokhin Russian Cancer Research Centre, Ministry of Healthcare of the Russian Federation.

I. A. Trofimov

Research Institute of Clinical and Experimental Radiology, Laboratory of Interventional Radiology
Russian Federation

Physician of Interventional Radiology Laboratory, Clinical and
Experimental Radiology Research Institute, N.N. Blokhin Russian Cancer Research Centre, Ministry of Healthcare of the
Russian Federation

O. V. Chistyakova

Research Institute of Clinical Oncology, Laboratory of Clinical Cytology of Pathology Department
Russian Federation
Cand. of Med. Sci., Leading Researcher of Clinical Cytology Laboratory Pathological Anatomy Division, N.N. Blokhin Russian Cancer Research Centre, Ministry of Healthcare of the Russian

Federation

E. A. Moroz

Research Institute of Clinical Oncology, Autopsy Department of Tumor Pathological Anatomy Department; N.N. Blokhin Russian Cancer Research Centre
Russian Federation

Cand. of Med. Sci., Senior Researcher of Pathological Anatomy Department, Pathological Anatomy Division, N.N. Blokhin Russian Cancer Research Centre, Ministry of Healthcare of the Russian Federation

I. V. Pogrebnyakov

Research Institute of Clinical and Experimental Radiology, Laboratory of Interventional Radiology
Russian Federation

Postgraduate Student of Clinical and Experimental Radiology Research Institute, N.N. Blokhin Russian Cancer Research Centre, Ministry of Healthcare of the Russian Federation

N. A. Shishkina

Research Institute of Clinical and Experimental Radiology, Laboratory of Interventional Radiology
Russian Federation

Radiologist of Interventional Radiology Laboratory, Clinical and Experimental Radiology Research Institute, N.N. Blokhin Russian Cancer Research Centre, Ministry of Healthcare of the Russian Federation

References

1. Сергеева О.Н., Долгушин Б.И., Кукушкин А.В., Панов В.О., Решетников А.В. Первый опыт внутрипротоковой фотодинамической терапии в лечение больных опухолями Клатскина. Тезисы докладов XVI Международного конгресса хирургов-гепатологов стран СНГ “Актуальные проблемы хирургической гепатологии”. Екатеринбург, 16–18 сентября 2009 г. С. 35. Sergeeva O.N., Dolgushin B.I., Kukushkin A.V., Panov V.O., Reshetnikov A.V. Pervyj opyt vnutriprotokovoj fotodinamicheskoj terapii v lechenie bol'nyh opuholjami Klatskina. [The first experience of inraductal photodynamic therapy in Klatskin tumor patients]. Abstracts of the XIV International Congress of hepato-pancreato-biliary-surgeons of CIS “Actual problems of surgical hepatology”. Ekaterinburg, 2009. P. 35. (In Russian)

2. Макаров Е.С. Внутрипротоковая лучевая терапия в комбинированном лечении рака магистральных желчных протоков (методика и предварительные результаты лечения): дисс. … канд. мед. наук. М., 1998. 113 с. Makarov E.S. Vnutriprotokovaja luchevaja terapija v kombinirovannom lecheniii raka magistral'nyh zhelchnyh protokov (metodika i predvaritel'nye rezul'taty lechenija) [Intraductal radiotherapy in complex treatment of main bile duct cancer (method and preliminary results)]: diss. … cand. of med. sci. Moscow, 1998. 113 p. (In Russian)

Review

For citations:

Dolgushin B.I., Sergeeva O.N., Frantsev D.Yu., Kukushkin A.V., Panov V.O., Virshke E.R., Kosyrev V.Yu., Cherkasov V.A., Trofimov I.A., Chistyakova O.V., Moroz E.A., Pogrebnyakov I.V., Shishkina N.A. Intraductal Photodynamic Therapy of Hilar Cholangiocarcinoma in Inoperable Patients. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2016;21(3):106-118. (In Russ.) https://doi.org/10.16931/1995-5464.20163106-118

This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 1995-5464 (Print)
ISSN 2408-9524 (Online)

Username
Password
	Remember me
Not a user? Register with this site Forgot your password?

Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery

Intraductal Photodynamic Therapy of Hilar Cholangiocarcinoma in Inoperable Patients

Full Text:

Abstract

Keywords

About the Authors

References

Review

For citations:

Журнал категории К1

[Распределение журналов, входящих в перечень рецензируемых научных изданий … по категориям]

В помощь авторам

User

Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery

Intraductal Photodynamic Therapy of Hilar Cholangiocarcinoma in Inoperable Patients

Full Text:

Abstract

Keywords

About the Authors

References

Review

For citations:

Журнал категории К1

[Распределение журналов, входящих в перечень рецензируемых научных изданий … по категориям]

В помощь авторам

Cookies policy