Abstract:

Objective

To systematically evaluate the safety and efficacy of photodynamic therapy

(PDT) in palliative treatment of advanced cholangiocarcinoma.

Methods

Studies related to PDT, palliative resection and simple stent implantation for advanced cholangiocarcinoma published from January 1, 2005 to January 30, 2023 were searched from PubMed, SCI, CNKI and Wanfang databases.Meta-analysis was carried out by RevMan 5.3 software.

Results

A total of 14 studies were included, including 12 studies consisting of 871 patients receiving PDT and stent drainage, and 2 studies comprising 159 cases undergoing PDT and palliative resection.Meta-analysis showed that compared with the stent drainage group, the incidence of overall complications (OR=0.87, 95%CI: 0.40-1.90) and cholangitis (OR=1.34, 95%CI: 0.80-2.25) had no statistical significance in the PDT group (both P＞0.05).Compared with the stent drainage group, the 1-, 2- and 3-year survival rates (OR=4.78, 95%CI: 2.02-11.33; OR=2.80, 95%CI: 1.35-5.78; OR=3.75, 95%CI: 1.09-12.93),and the median survival (OR=6.23, 95%CI: 6.07-6.40) were significantly better in the PDT group (all P＜0.05).However, there were no significant differences in 1-year (OR=0.69, 95%CI: 0.34-1.38) and 3-year survival rates (OR=0.60, 95%CI: 0.27-1.34) between the PDT and palliative resection groups (both P＞0.05).

Conclusions

PDT can improve the survival of patients with advanced cholangiocarcinoma receiving palliative treatment.PDT yields equivalent efficacy to palliative resection and has multiple advantages of safety, rapid recovery, mild trauma and repeated use, which is a promising treatment for advanced cholangiocarcinoma.

Key words: Bile duct neoplasms, Palliative resection, Photodynamic therapy, Biliary stent, Meta-analysis