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Photodynamic therapy for non-resectable perihilar cholangiocarcinoma

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Abstract

Photodynamic therapy (PDT) has emerged as a useful tool for palliative treatment of the otherwise difficult to treat perihilar cholangiocarcinoma (CC). PDT is a minimally invasive and effective technique for local tumour ablation with rare and predictable side effects. A modest number of studies and randomised trials using porfimer (Photofrin®) could demonstrate an improvement in quality of life and survival time. A novel approach to a priori non-resectable perihilar CC was proven in a pilot study using neoadjuvant porfimer-PDT for down-sizing of the tumour followed by R0 resection. These days, active phase II and phase III trials investigate if the tumouricidal activity can be increased using temoporfin (Foscan®) as an alternative photosensitiser with higher penetration capability and whether porfimer-based PDT plus stenting is superior to biliary stenting alone in terms of overall survival, respectively. The local tumour ablation and correction of obstructive cholestasis with PDT will allow for novel multimodal strategies to treat cholangiocarcinoma.

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  1. Department of Internal Medicine I, Paracelsus Medical University Salzburg, Muellner Hauptstrasse 48, 5020, Salzburg, Austria

    Tobias Kiesslich, Gernot Wolkersdörfer, Hermann Salmhofer & Frieder Berr

  2. Institute of Pathology, University Hospital Salzburg, Paracelsus Medical University, Muellner Hauptstrasse 48, Salzburg, Austria

    Daniel Neureiter

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  1. Tobias Kiesslich
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Kiesslich, T., Wolkersdörfer, G., Neureiter, D. et al. Photodynamic therapy for non-resectable perihilar cholangiocarcinoma. Photochem Photobiol Sci 8, 23–30 (2009). https://doi.org/10.1039/b813183j

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