Department of Gastroenterology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, China.
J Hepatobiliary Pancreat Sci. 2010 Mar;17(2):125-31. doi: 10.1007/s00534-009-0109-3. Epub 2009 May 20.
Palliative therapies for unresectable cholangiocarcinoma such as stent, radiotherapy and chemotherapy have generally been disappointing. Therefore, it is necessary to find a new approach to fighting the disease. Several published clinical trials have reported the therapeutic effect of photodynamic therapy (PDT) for unresectable cholangiocarcinoma.
To assess the safety and efficacy of photodynamic therapy for patients with unresectable cholangiocarcinoma.
Relevant studies were retrieved from the Medline, Current Contents, Embase, and Cochrane Library databases. Inclusion of papers was determined by using a predetermined protocol; independent assessments and the final consensus decision were performed by two independent reviewers. Acceptable study designs included randomized controlled trials (RCTs), controlled clinical trials (CCTs), case studies, and case reports. Twenty studies met the inclusion criteria, and were tabulated and critically appraised in terms of characteristics, methods, outcomes, and complications.
Twenty studies were included. The quality of the available evidence was low to moderate with the majority of studies being uncontrolled before and after design and thus limited by the retrospective nature of much of the available data. After PDT, it is reported that bilirubin serum levels declined, quality of life improved and survival time increased in most of the patients. At the same time, there were few complications.
Based on currently available evidence, PDT was safe and effective for patients with inoperable cholangiocarcinoma.
对于无法切除的胆管癌，如支架、放疗和化疗等姑息性治疗通常效果不佳。因此，有必要寻找新的治疗方法。一些已发表的临床试验报告了光动力疗法（PDT）治疗不可切除的胆管癌的疗效。
评估光动力疗法治疗不可切除的胆管癌患者的安全性和疗效。
从 Medline、Current Contents、Embase 和 Cochrane Library 数据库中检索相关研究。使用预定的方案确定论文的纳入标准；由两名独立的评审员进行独立评估和最终共识决策。可接受的研究设计包括随机对照试验（RCT）、对照临床试验（CCT）、病例研究和病例报告。符合纳入标准的研究有 20 项，对其特征、方法、结果和并发症进行了列表和批判性评估。
共纳入 20 项研究。现有证据的质量为低到中度，大多数研究在设计前后均为非对照，因此受到大量现有数据的回顾性性质的限制。在 PDT 后，大多数患者的胆红素血清水平下降，生活质量改善，生存时间延长。同时，并发症较少。
基于现有证据，PDT 治疗不可切除的胆管癌是安全有效的。
