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Title: Yttrium-90 Radioembolization for Unresectable Combined Hepatocellular-Cholangiocarcinoma

Abstract

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 bymore » 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.« less

Authors:
;  [1];  [2]; ; ;  [1]
  1. Stanford University School of Medicine, Division of Interventional Radiology (United States)
  2. Stanford University School of Medicine, Department of Surgery (United States)
Publication Date:
OSTI Identifier:
22756428
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 40; Journal Issue: 9; Other Information: Copyright (c) 2017 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOLOGICAL MARKERS; MICROSPHERES; NEOPLASMS; PATIENTS; RADIOEMBOLIZATION; TOXICITY; YTTRIUM 90

Citation Formats

Chan, Lauren S., Sze, Daniel Y., Poultsides, George A., Louie, John D., Abdelrazek Mohammed, Mohammed A., and Wang, David S., E-mail: davidwang@stanford.edu. Yttrium-90 Radioembolization for Unresectable Combined Hepatocellular-Cholangiocarcinoma. United States: N. p., 2017. Web. doi:10.1007/S00270-017-1648-7.
Chan, Lauren S., Sze, Daniel Y., Poultsides, George A., Louie, John D., Abdelrazek Mohammed, Mohammed A., & Wang, David S., E-mail: davidwang@stanford.edu. Yttrium-90 Radioembolization for Unresectable Combined Hepatocellular-Cholangiocarcinoma. United States. doi:10.1007/S00270-017-1648-7.
Chan, Lauren S., Sze, Daniel Y., Poultsides, George A., Louie, John D., Abdelrazek Mohammed, Mohammed A., and Wang, David S., E-mail: davidwang@stanford.edu. Fri . "Yttrium-90 Radioembolization for Unresectable Combined Hepatocellular-Cholangiocarcinoma". United States. doi:10.1007/S00270-017-1648-7.
@article{osti_22756428,
title = {Yttrium-90 Radioembolization for Unresectable Combined Hepatocellular-Cholangiocarcinoma},
author = {Chan, Lauren S. and Sze, Daniel Y. and Poultsides, George A. and Louie, John D. and Abdelrazek Mohammed, Mohammed A. and Wang, David S., E-mail: davidwang@stanford.edu},
abstractNote = {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.},
doi = {10.1007/S00270-017-1648-7},
journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 9,
volume = 40,
place = {United States},
year = {2017},
month = {9}
}