Keywords:
Liver, Interventional non-vascular, Oncology, MR, Digital radiography, Biopsy, Cholangiography, Drainage
Authors:
D. Frantsev, O. N. Sergeeva, M. A. Shorikov, M. Lapteva, E. Virshke, B. Dolgushin; MOSCOW/RU
DOI:
10.26044/ecr2019/C-1461
Aims and objectives
Cholangiocarcinoma is the second most common primary malignant tumor of the liver.
Klatskin tumor or hilar cholangiocarcinoma represents more than 50% of all biliary tract cholangiocarcinomas [1].
The natura history of Klatskin tumors is dramatic.
The median survival without interventions reaches three months,
and it may be prolonged by drainage from four to ten months [2].
The patients die mainly due to jaundice,
cholangitis,
liver failure,
complications of portal hypertension and cachexia.
The majority of patients are not surgical candidates,
so other therapies are required toincrease their survival and improve the quality of life ( Fig. 1 ).
Endobiliary photodynamic therapy (EPDT) - is a binary tumor destruction procedure implying more or less specific accumulation of intravenously injected agent named photosensitizer by proliferative cells and inflammatory tissue following by intraductal laser irradiation ( Fig. 2 ,
Fig. 3 ).
According to the literature the treatment of cholangiocarcinoma with endobiliary PDT is associated with an increased survival benefit,
an improved biliary drainage,
and a better quality of life ( Fig. 4 ).
Varying intraductal light delivery equipment,
irradiation regimen and light doses as well different photosensitizers using for EPDT may impact its safety.
Identification of factors influencing EPDT tolerability in non-surgical Klatskin tumor patients is the purpose of the paper.