Table 2. List of studies utilizing photodynamic therapy (PDT) for cholangiocarcinoma (CCA).
| Study | Year | Type | N | Technique | Location | # of sessions (mean) | TB before | TB after | Stent type | Survival | Adverse events |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Yang et al. (12) | 2016 | Prospective controlled | 39 | Endoscopic PDT + stent [12] vs. stent alone [27] | Bismuth I–II [24]; III–IV [15] | 3.5–4.8 | PDT + stent: 245.4±86.5. Stent: 265.8±96.8 | PDT + stent: 21.7±7.9. Stent: 32.8 ±9.6 | Plastic | PDT + stent: 14.9±5.8. Stent: 8.0±2.5 | Cholangitis, stent migration |
| Wentrup et al. (13) | 2016 | Retrospective | 68 | Endoscopic PDT monotherapy [35] vs. PDT + chemotherapy [33] | Bismuth I [1]; II [4]; III [4]; IV [59] | 1–4 | – | – | Plastic | PDT-M: 374 days. PDT-C: 520 days. (mean) | Cholangitic complications [52] |
| Kahaleh et al. (14) | 2008 | Retrospective | 48 | Endoscopic PDT + stent [19] vs. stent alone [29] | Bismuth I [3]; II [9]; III [17]; IV [19] | 1–3 (1.8) | – | – | Plastic | PDT + stent: 16.8 months. Stent: 7.4 months. (mean) | Cholangitis (17, 2 deaths in the stent group), liver abscess [2], pancreatitis [4], hemobilia [2], cholecystitis [2] |
| Hong et al. (15) | 2014 | Retrospective cohort | 74 | PDT monotherapy [58] vs. PDT + chemotherapy [16] (endoscopic 15, percutaneous 59) | Bismuth II [2]; IIIa [11]; IIIb [18], IV [39] | 1 – 2 | – | – | Plastic | PDT-M: 11.1 months. PDT-C: 17.9 months (median) | Cholangitis [4], phototoxicity [2], liver abscess [2], percutaneous tube occlusion [2] and leakage [2] |
| Cheon et al. (16) | 2012 | Retrospective | 143 | PDT + stent [72] vs. stent alone [71] (endoscopic 13, percutaneous 59) | Bismuth II [31]; IIIa [29]; IIIb [38]; IVa [31]; IVb [34] | 1–4 [1] | PDT + stent: 11.3; stent 10.5 | PDT + stent: 2.8; stent: 3.6 | Plastic [54], metallic [18] | PDT + stent: 9.8 months. Stent: 7.3 months (median) | Skin hyperpigmentation [10], biliary leakage [1], sepsis [1], liver abscess [1], infected biloma [2], stent migration [10] |
| Park et al. (40) | 2014 | RCT | 43 | PDT monotherapy [22] vs. PDT + chemotherapy 21]. (endoscopic 32, percutaneous 11) | Bismuth II [6]; III [9]; IV [28] | 2.2–2.9 | PDT-M: 8.4±9.3; PDT-C: 6.7±6.4 | PDT-M: 1.7±1.9; PDT-C: 1.6±0.9 | Plastic | PDT-M: 8 months. PDT-C: 17 months (median) | Cholangitis, liver abscess, photosensitivity |
| Pereira et al. (41) | 2012 | Prospective cohort | 36 | Endoscopic PDT + stent | Bismuth I [1], II [2], III [12], IV [7] | 1 | – | – | – | 12 months (median) | Abdominal pain [17], sepsis [5], photosensitivity [4] |
| Weigt et al. (42) | 2011 | Retrospective | 53 | PDT + stent [25] vs. stent alone [28] | – | 1–8 [2] | – | – | – | PDT + stent: 478±71 days. Stent: 220±61 days |
Cholangiosepsis [4]; liver abscess [3]; phototoxicity [1] |
| Quyn et al. (43) | 2009 | Prospective controlled | 50 | Resection [10] vs. stent + chemo [17] vs. PDT [23] (endoscopic 19, percutaneous 4] | Bismuth II [4]; IIIa [17]; IIIb [6]; IV [23] | 1 | – | – | Plastic or metallic | Resection: 1,278 days. Chemo ± stent: 173 days. PDT + stent: 512 days (mean) | Abdominal pain [10], hemobilia [2], sepsis [5], photosensitivity [4] |
| Fuks et al. (44) | 2009 | Prospective cohort | 14 | PDT + stent (endoscopic 12, percutaneous 2) | Bismuth II [2]; III [4]; IV [1]; CBD [4]; gallbladder [2]; intra-hepatic [1] | 1–6 [2] | – | – | Plastic [12], metallic [2] | 13.8 months (median) | Abdominal pain [1], phototoxicity [2], cholangitis (8, with 1 death), stent migration [3], contained duodenal perforation [1] |
| Witzigmann et al. (45) | 2006 | Prospective controlled | 184 | Resection [60]; PDT + stent [68]; stent alone [56] | Bismuth I [14]; II [22]; IIIa [22]; IIIb [26]; IV [100] | 1–6 [2] | – | – | Plastic | PDT + stent: 12 months. Stent: 6.4 months (median) | Cholangitis [70], phototoxicity [2], pancreatitis [2]; bleeding [2]; perforation [1] |
| Zoepf et al. (46) | 2005 | RCT | 32 | PDT + stent [16] vs. stent alone [16] (endoscopic 18, percutaneous 14) | Bismuth II [1]; IV [31] | 1–2 | Stent: 3.6; PDT + stent: 2.75 | Stent: 2.4; PDT + stent: 1.3 | Plastic | PDT + stent: 21 months. Stent: 7 months. (median) | Cholangitis [1], biloma [3], cholecystitis [1] |
| Ortner et al. (47) | 2003 | RCT | 39 | PDT + stent [20] vs. stent alone [19] | Bismuth II [2]; III [6]; IV [31] | 1–5 (2.4) | – | – | Plastic | PDT + stent: 493 days. Stent: 98 days. (median) | Cholangitis [10], photosensitivity [2], 8 deaths related to cholangiosepsis |
TB, total bilirubin; PDT, photodynamic therapy; PDT-M, photodynamic monotherapy; PDT-C, photodynamic therapy + chemotherapy.