Yttrium-90 Radioembolization for Unresectable Combined Hepatocellular-Cholangiocarcinoma

Journal Article · Fri Sep 15 04:00:00 EDT 2017 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-017-1648-7· OSTI ID:22756428

Chan, Lauren S.; Sze, Daniel Y. ^[1]; Poultsides, George A. ^[2]; Louie, John D.; Abdelrazek Mohammed, Mohammed A.

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1. Stanford University School of Medicine, Division of Interventional Radiology (United States)
2. Stanford University School of Medicine, Department of Surgery (United States)

PurposeCombined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare mixed cell type primary liver cancer with limited data to guide management. Transarterial radioembolization with yttrium-90 microspheres (RE) is an emerging treatment option for both hepatocellular carcinoma and intrahepatic cholangiocarcinoma. This study explored the safety and efficacy of RE for unresectable cHCC-CC.MethodsPatients with histopathologically confirmed cHCC-CC treated with RE were retrospectively evaluated. Clinical and biochemical toxicities were assessed using the Common Toxicity Criteria for Adverse Events v4.03. Radiological response was analyzed using the Response Criteria in Solid Tumors (RECIST) v1.1 and modified RECIST criteria. Survival times were calculated and prognostic variables identified.ResultsTen patients (median age 59 years; six men, four women) with unresectable cHCC-CC underwent 14 RE treatments with resin (n = 6 patients) or glass (n = 4 patients) microspheres. Clinical toxicities were limited to grade 1–2 fatigue, anorexia, nausea, or abdominal pain. No significant biochemical toxicities were observed. Median overall survivals from the first RE treatment and from initial diagnosis were 10.2 and 17.7 months, respectively. Six of seven patients with elevated tumor biomarker levels before RE showed decreased levels after treatment (median decrease of 72%, range 13–80%). Best hepatic radiological response was 60% partial response and 40% stable disease by modified RECIST, and 100% stable disease by RECIST v1.1. Poor performance status and the presence of macrovascular invasion were identified as predictors of reduced survival after RE.ConclusionRE appears to be a safe and promising treatment option for patients with unresectable cHCC-CC. Level of Evidence: Level 4.

• OSTI ID: 22756428
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 9 Vol. 40; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOLOGICAL MARKERS
MICROSPHERES
NEOPLASMS
PATIENTS
RADIOEMBOLIZATION
TOXICITY
YTTRIUM 90