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Combined stenting and photodynamic therapy improves survival in late stage liver cancer patients
Date:3/11/2008

ercent respectively. The difference between the two groups was significant at three and six months, but not at 12 months. Upon further analysis, the team found that only the number of ERCP procedures and number of PDT sessions were significant in determining survival. In both groups, serum bilirubin was successfully reduced.

PDT is an evolving therapy that involves administering a photosensitizing agent and activating it using light illumination of a specific wavelength, which kills the targeted cells. PDT is thought to destroy cancer and neovascular cells and reduce tumor mass, and in earlier prospective trials, PDT was associated with a significant reduction in bilirubin (a red blood cell byproduct excreted in liver bile) and increased survival compared to historical data.

While we are pleased with the results of the study, we need to better understand if the effect is attributable primarily to the photodynamic therapy or to the number of ERCP sessions, said Dr. Kahaleh.

Adverse events specific to PDT included three patients with skin phototoxicity requiring topical therapy. Complications in the stent-only group included patients developing cholangitis after therapy with two patients dying as a consequence. Post ERCP pancreatitis was observed in four patients and duodenal perforation in one. Other adverse events in the stent group included a liver abscess (1), perforation (1) and non-St elevation myocardial infarction, or heart attack (2). In the PDT group, seven patients (37 percent) developed cholangitis treated with antibiotics alone. No patients had contraindications to photodynamic therapy contrast agents, and all patients received prophylactic antibiotics prior to the procedures.

Analyses were performed to detect predictors of survival, including MELD score (Model for End-stage Liver Disease, the extent of the disease), age, treatment by chemotherapy or radiation, and number of ERCP procedures and PDT sessions. Succes
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Contact: Aimee Frank
media@gastro.org
301-941-2620
American Gastroenterological Association
Source:Eurekalert

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