Efficiency Evaluation of Photodynamic Therapy With Photofrin® on Unresectable Type III or IV Cholangiocarcinomas (CK/PDT)

Inclusion Criteria:

• Obtention of a written informed consent.
• Patient over 18.
• Patient with a type III or IV (according to Bismuth classification) histologically proved cholangiocarcinoma ; histologic diagnosis must be proved by biliary brushing, bile cytology, endobiliary biopsy under scope control with pediatric pliers, or by cytologic puncture under scan or echoendscopic control.
• Patient with Karnofsky score ≥ 50 %
• Patient with an efficient initial biliary drainage with prothesis.
• Cancer classified maximum T3N1M1, but only with intrahepatic metastasis occupying less than 25% of hepatic parenchyme (according to TNM cancer classification of extrahepatic biliary ducts' cancers).
• Patient capable of fill in the quality of life questionnaire.

Exclusion Criteria:

• No written informed consent.
• Type I and II cholangiocarcinoma according to Bismuth classification.
• Patients with ASA score 4.
• Patients with clinical and biological signs of biliary infection.
• Patients with a severe visceral disease other than cholangiocarcinoma.
• Patients without an efficient initial biliary drainage.
• Patients with extrahepatic visceral metastasis, except perihilar ganglionic metastasis classified T4N1M+ according to TNM classification.
• Patients whose cholangiocarcinoma has already been resected.
• Patients under or already treated by radiotherapy or chemotherapy treatment for cholangiocarcinoma.
• Patients first treated with metallic prothesis.
• Patients with a contraindication to MRI.
• Patients with porphyria or hypersensibility to porphyrins.
• Patient treated by a non authorized treatment at the time of inclusion.
• Pregnant, parturient or breastfeeding women.
• Non menopaused woman without an efficient contraception.
• Patient under 18.
• Person over 18 under protection according to French Public Health Code.
• Person not affiliated to a social security regimen, or benefiting from such a regimen.
• Person in a exclusion period of another biomedical study.