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首页> 外文期刊>Current opinion in gastroenterology >Photodynamic therapy for cholangiocarcinoma: overview and new developments.
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Photodynamic therapy for cholangiocarcinoma: overview and new developments.

机译：胆管癌的光动力疗法：概述和新进展。

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PURPOSE OF REVIEW: Photodynamic therapy (PDT) with hematoporphyrins has emerged as promising treatment for nonresectable cholangiocarcinoma in several prospective observational studies and two randomized studies. This review describes the mechanism of action of PDT, gives an overview of clinical experience in cholangiocarcinoma and summarizes the results published in 2007 and 2008. RECENT FINDINGS: The mechanism of action of PDT has been further elucidated. PDT induces an apoptotic, antiangiogenic as well as an immunomodulatory response. Interleukin-6, a bile duct epithelium growth factor correlating with tumor burden, decreases after PDT. The efficacy of PDT was confirmed in a comparative study in the United States. Patients with no visible mass on imaging studies, high serum albumin levels and treatment immediately after diagnosis seem to benefit most from PDT. Although it is recommended to perform PDT in bile ducts without stents in place, illumination through metal stents is possible if the light dose is adjusted. Meso-tetrahydroxyphenyl chlorine is a new potent photosensitizer for PDT of cholangiocarcinoma. SUMMARY: In advanced nonresectable cholangiocarcinoma, PDT is the only evidence-based treatment that improves survival when compared with stenting. Therefore, PDT should be offered to those who are unsuitable for surgery.
机译：审查的目的：在一些前瞻性观察研究和两项随机研究中，血卟啉的光动力疗法（PDT）已成为治疗不可切除胆管癌的有前途的治疗方法。这篇综述描述了PDT的作用机理，概述了胆管癌的临床经验，并总结了2007年和2008年发表的结果。最近的发现：PDT的作用机理得到了进一步的阐明。 PDT诱导凋亡，抗血管生成以及免疫调节反应。白细胞介素6（一种与肿瘤负荷相关的胆管上皮生长因子）在PDT后降低。在美国的一项比较研究中证实了PDT的功效。影像学检查无明显肿块，血清白蛋白水平高且诊断后立即接受治疗的患者似乎从PDT中受益最多。尽管建议在没有放置支架的情况下在胆管中进行PDT，但是如果调整光剂量，则可以通过金属支架进行照明。内四羟基苯氯是用于胆管癌PDT的新型有效光敏剂。摘要：在晚期不可切除的胆管癌中，PDT是与支架置入术相比能够提高生存率的唯一基于证据的治疗方法。因此，PDT应该提供给不适合手术的人。

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