Transarterial Hepatic Yttrium-90 Radioembolization in Patients with Unresectable Intrahepatic Cholangiocarcinoma: Factors Associated with Prolonged Survival

Journal Article · Wed Feb 15 00:00:00 EST 2012 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-011-0142-X· OSTI ID:21608625

Hoffmann, Ralf-T; Schoen, Agnes ^[1]; Bamberg, Fabian ^[2]; Haug, Alexander ^[3]; Duerr, Eva-Maria; Rauch, Barbara ^[1]; Trumm, Christoph T; Jakobs, Tobias F ^[2]; Helmberger, Thomas K ^[4]; Reiser, Maximilian F ^[2]; Kolligs, Frank T ^[1]

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1. Ludwig-Maximilians-University, Department of Medicine II (Germany)
2. Ludwig-Maximilians-University, Institute of Clinical Radiology (Germany)
3. Ludwig-Maximilians-University, Department of Nuclear Medicine (Germany)
4. Klinikum Bogenhausen, Department of Radiology, Interventional Radiology and Nuclear Medicine (Germany)

Introduction: In unresectable intrahepatic cholangiocarcinoma (ICC), systemic chemotherapy often is viewed as the only option, although efficacy is limited. Radioembolization (RE) using yttrium-90 ({sup 90}Y) microspheres is an accepted therapy for patients with hepatocellular-carcinoma or metastatic liver tumors. However, there are limited data on the value of RE in patients with ICC and few data on factors influencing prognosis. The purpose of our retrospective analysis was to establish which factors influenced time-to-progression (TTP) and overall survival (OS). Methods: Patients with unresectable ICC were treated with {sup 90}Y resin-microspheres and assessed at 3-monthly intervals. Radiologic response was evaluated by using Response Criteria in Solid Tumors (RECIST). Baseline characteristics, biochemical/clinical toxicities, and response were examined for impact on TTP and OS. Results: Thirty-four treatments were administered to 33 patients without major complications. By RECIST, 12 patients had a partial response, 17 had stable disease, and 5 had progressive disease after 3 months. The median OS was 22 months posttreatment and 43.7 months postdiagnosis. Median TTP was 9.8 months. Survival and TTP were significantly prolonged in patients with ECOG 0 (vs. ECOG 1 or 2; median OS: 29.4, 10, and 5.1 months; TTP: 17.5, 6.9, and 2.4 months), tumor burden {<=}25% (OS: 26.7 vs. 6 months; TTP: 17.5 vs. 2.3 months), or tumor response (PR or SD vs. PD; OS: 35.5, 17.7 vs. 5.7 months; TTP: 31.9, 9.8 vs. 2.5 months), respectively (P < 0.001). Conclusions: Radioembolization is an effective and safe option for patients with unresectable ICC. Predictors for prolonged survival are performance status, tumor burden, and RECIST response.

• OSTI ID: 21608625
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 35, Issue 1; Other Information: DOI: 10.1007/s00270-011-0142-x; Copyright (c) 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CHEMOTHERAPY
HEPATOMAS
LIVER
METASTASES
MICROSPHERES
PATIENTS
TOXICITY
YTTRIUM 90
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
CARCINOMAS
DAYS LIVING RADIOISOTOPES
DIGESTIVE SYSTEM
DISEASES
GLANDS
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
NEOPLASMS
NUCLEI
ODD-ODD NUCLEI
ORGANS
RADIOISOTOPES
THERAPY
YTTRIUM ISOTOPES