Photodynamic therapy for cholangiocarcinoma

The only hope for cure in patients with cholangiocarcinoma is curative surgical resection. Unfortunately it can only performed in less than half of the patients. In the palliative setting endoprostheses insertion improves cholestasis. Survival time is not prolonged. The most promising conventional antitumoral therapy is chemotherapy with cisplatin and gemcitabine. However, randomized trials showing a clear survival advantage of chemo- or radiotherapy are missing. Photodynamic therapy utilizing photo-physical properties of light-absorbing drugs to efficiently generate reactive cytotoxic oxygen species has shown efficacy in several pilot studies, retrospective comparative studies and two prospective, randomized studies. Here, we review mechanism of action, technique, and efficacy of photodynamic therapy for cholangiocarcinoma.