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Two cases of bile duct carcinoma patients who underwent the photodynamic therapy using talaporfin sodium (Laserphyrin®)

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Abstract

The efficacy of adjuvant photodynamic therapy (PDT) using the new photosensitizer, talaporfin sodium (TPS) has been clinically examined in some patients with bile duct carcinoma (BDC). Based on our previous cohorts, a prospective clinical trial was attempted; however, only two cases were ultimately enrolled in 27 months. A 664-nm semiconductor laser (100 J/cm2) was applied through an endoscope to the tumor lesion within 6 h of an intravenous injection of 40 mg/m2 TPS according to the protocol for lung cancer. Case 1 was an 82-y.o. female patient with BDC at the left hepatic duct with biliary obstruction, percutaneous transhepatic biliary drainage (PTBD) was achieved, and the patient did not consent to surgery. She was followed up for 15 months to search for non-surgical treatments and eventually received PDT. Although mild photosensitivity occurred, she was discharged without severe adverse events. Biliary stenosis markedly extended and a PTBD tube was scheduled at 1 month. However, cancer immediately metastasized to the liver and she died 155 days after PDT. Case 2 was a 70-y.o. female with perihilar BDC and multiple biliary stenoses. Multiple biliary stenting was considered to be difficult. She received PDT and no adverse events were observed. Biliary stenoses markedly improved and multiple stenting was successfully performed. On day 132, she died of cancer progression. These two cases demonstrated the safety and efficacy of biliary malignant stenosis soon after PDT; however, long-term survival and a sufficient quality of life were not achieved. The combination of the PDT protocol and system chemotherapy or brachytherapy needs to be examined in clinical trials for advanced stage BDC.

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Acknowledgements

We gratefully appreciate the cooperation of the Ethics Committee of the Clinical Research Center at the University of Miyazaki Faculty of Medicine, namely, Prof. K. Itai, Associate Prof. S. Iwae, Ms. K. Yamada, Ms. H. Morita, and other paramedical staff who supported this treatment. This study was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education (19K09178), Science, Sports and Culture of Japan, and a Clinical research Grant 2019 from the Japanese Society of Gastroenterology (JSGE Grant).

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Authors and Affiliations

  1. Division of Hepato-Biliary-Pancreas Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Atsushi Nanashima, Masahide Hiyoshi, Naoya Imamura, Takeomi Hamada, Koichi Yano & Takashi Wada

  2. Division of Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan

    Takahiro Nishida & Shinsuke Takeno

  3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Miyazaki Faculty of Medicine, Miyazaki, Japan

    Hiroshi Kawakami, Tesshin Ban, Yoshimasa Kubota & Koji Nakashima

  4. Department of Surgery, Miyazaki Medical Association Hospital, Miyazaki, Japan

    Masahiro Kai

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  1. Atsushi Nanashima
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  2. Masahide Hiyoshi
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Correspondence to Atsushi Nanashima.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Nanashima, A., Hiyoshi, M., Imamura, N. et al. Two cases of bile duct carcinoma patients who underwent the photodynamic therapy using talaporfin sodium (Laserphyrin®). Clin J Gastroenterol 13, 102–109 (2020). https://doi.org/10.1007/s12328-019-01006-5

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  • DOI: https://doi.org/10.1007/s12328-019-01006-5

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