Photodynamic therapy of inoperable cancer of extrahepatic bile ducts and large duodenal papilla

The article presents findings obtained in patients with inoperable cancer tumors of different departments of extrahepatic bile ducts and the large duodenal papilla after they had been treated with photodynamic therapy. The applied technique is described; different options of laser light delivery to different segments of the biliary tract are discussed. After the statistical processing, the researchers could define PDT reasonability, efficiency and frequency of repeated sessions. There were 28 patients: 8 men (32.1%) and 19 women (67.9%). The average age was 68.5 years. In all cases adenocarcinoma of various differentiation degrees was revealed. Cancer of the large duodenal papilla was in 20 (71.4%) patients, cancer of the common bile duct in 3 patients (10.7%), cancer of the liver port in 1 patient (3.6%), and cancer of the gall bladder in 4 patients (14.3%). Photoditazine and Photosense were used as photosensitizers. In the present work, the researchers evaluated PDT effectiveness for treating inoperable cancer in various departments of the biliary tract depending on the number of PDT sessions and the group of photosensitizers. Patients were divided into several groups. Outcomes were assessed by determining the median survival by Kaplan-Meer methods. Results. The median survival time in the main group was 18 months (minimum -12.5 months, maximum - 24 months); in the comparison group - 11.5 months (minimum - 4 months, maximum - 14 months). The median survival time in the group treated with Photoditazine was 17 months (CI-95%: 12; 21); in the Photosense group - 18 months (CI 95%: 16, 19). There were no lethal outcomes. In patients who had only one PDT session during the year, the median survival was 12.5 months (95% CI: 10, 15); in patients who had 2 or more PDT sessions, the median survival was 23 months (95% CI: 18, 28).

рак внепеченочных желчных протоков, рак большого дуоденального сосочка, фотодинамическая терапия, extrahepatic bile duct cancer, large duodenal papilla cancer, photodynamic therapy

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