Benefits and safety of photodynamic therapy in patients with hilar cholangiocarcinoma: A meta-analysis

Photodiagnosis Photodyn Ther. 2022 Mar:37:102712. doi: 10.1016/j.pdpdt.2022.102712. Epub 2022 Jan 5.

Abstract

Background: Photodynamic therapy (PDT) is a therapy evaluated for the treatment of cancers resistant to standard oncological treatments. PDT might be beneficial for the palliation of hilar cholangiocarcinoma.

Aim: To evaluate the efficacy and safety of PDT for treating hilar cholangiocarcinoma.

Methods: PubMed, Embase, the Cochrane Library, and Web of Science were searched for articles published up to May 2021. The patients were grouped as PDT+stent vs. stent alone. The outcomes were survival, quality of life, and adverse events (AEs). Data were summarized using hazard ratios (HRs), odds ratios (ORs), and 95% confidence intervals (CIs).

Results: Six studies were included in this meta-analysis. There were 235 and 211 patients in the PDT+stent and stent groups, respectively. The 1-year survival rate of the PDT+stent group was 0.56, and that of the control group was 0.25. The 2-year survival rate of the PDT+stent group was 0.16, and that of the control group was 0.07. PDT significantly prolonged overall survival compared to the controls (P = 0.002). No differences were detected in the occurrence of cholangitis (P = 0.996) and all other AEs (early complications, stent malfunction, total AEs, acute pancreatitis, liver abscess, and biliary hemorrhage) between the two groups.

Conclusion: PDT in patients with hilar cholangiocarcinoma could improve survival without additional AEs. Large-scale randomized controlled trials are needed to confirm the findings.

Keywords: Biliary stent; Hepatobiliary cancer; Hilar cholangiocarcinoma; Meta-analysis; Palliative treatment; Photodynamic therapy.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Acute Disease
  • Bile Duct Neoplasms* / drug therapy
  • Bile Ducts, Intrahepatic / pathology
  • Cholangiocarcinoma* / drug therapy
  • Humans
  • Klatskin Tumor* / drug therapy
  • Klatskin Tumor* / etiology
  • Klatskin Tumor* / pathology
  • Pancreatitis* / etiology
  • Pancreatitis* / pathology
  • Photochemotherapy* / methods
  • Quality of Life
  • Stents
  • Treatment Outcome