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Yttrium-90 Radioembolization in Intrahepatic Cholangiocarcinoma: A Multicenter Retrospective Analysis.
Journal of Vascular and Interventional Radiology ( IF 2.6 ) Pub Date : 2020-05-28 , DOI: 10.1016/j.jvir.2020.02.008
Stefan Buettner 1 , Arthur J A T Braat 2 , Georgios Antonios Margonis 3 , Daniel B Brown 4 , Kevin B Taylor 4 , Anthony J Borgmann 4 , S Cheenu Kappadath 5 , Armeen Mahvash 6 , Jan N M IJzermans 1 , Matthew J Weiss 3 , Angela Lamarca 7 , Jon K Bell 8 , Juan W Valle 7 , Jeroen Hagendoorn 9 , Bas Groot Koerkamp 1 , Daniel Y Sze 10 , Marnix G E H Lam 2
Affiliation  

Purpose

To report outcomes of yttrium-90 (90Y) radioembolization in patients with unresectable intrahepatic cholangiocarcinoma (ICC).

Materials and Methods

Retrospective review was performed of 115 patients at 6 tertiary care centers; 92 were treated with resin microspheres (80%), 22 were treated with glass microspheres (19%), and 1 was treated with both. Postintervention outcomes were compared between groups with χ2 tests. Survival after diagnosis and after treatment was assessed by Kaplan–Meier method.

Results

Grade 3 laboratory toxicity was observed in 4 patients (4%); no difference in toxicity profile between resin and glass microspheres was observed (P = .350). Clinical toxicity per Society of Interventional Radiology criteria was noted in 29 patients (25%). Partial response per Response Evaluation Criteria In Solid Tumors 1.1 was noted in 25% of patients who underwent embolization with glass microspheres and 3% of patients who were treated with resin microspheres (P = .008). Median overall survival (OS) from first diagnosis was 29 months (95% confidence interval [CI], 21–37 mo) for all patients, and 1-, 3-, and 5-year OS rates were 85%, 31%, and 8%, respectively. Median OS after treatment was 11 months (95% CI, 8–13 mo), and 1- and 3-year OS rates were 44% and 4%, respectively. These estimates were not significantly different between resin and glass microspheres (P = .730 and P = .475, respectively). Five patients were able to undergo curative-intent resection after 90Y radioembolization (4%).

Conclusions

This study provides observational data of treatment outcomes after 90Y radioembolization in patients with unresectable ICC.



中文翻译:

肝内胆管癌中Yttrium-90放射栓塞:多中心回顾性分析。

目的

报告无法手术切除的肝内胆管癌(ICC)患者钇90(90 Y)放射栓塞的结果。

材料和方法

在6个三级护理中心对115例患者进行了回顾性审查;用树脂微球(80%)处理了92个,用玻璃微球(19%)处理了22个,并用两者均处理了1个。干预后的结果用χ组间比较2测试。诊断后和治疗后的生存率通过Kaplan-Meier方法进行评估。

结果

在4名患者中观察到了3级实验室毒性(4%);没有观察到树脂和玻璃微球在毒性方面的差异(P =。350)。根据介入放射学会标准,有29名患者(25%)出现临床毒性。根据实体肿瘤中每个缓解评估标准的部分缓解,在玻璃微球栓塞患者中有25%的患者为1.1%,树脂微球治疗患者中为3%(P =。008)。所有患者从初诊起的中位总生存期(OS)为29个月(95%置信区间[CI],21-37 mo),并且1年,3年和5年OS率分别为85%,31%,和8%。治疗后OS的中位数为11个月(95%CI,8-13 mo),而1年和3年OS率分别为44%和4%。这些估计在树脂微球和玻璃微球之间没有显着差异(分别为P = 730和P = .475)。五例患者在90 Y放射栓塞后能够进行根治性切除(4%)。

结论

这项研究提供了不可切除ICC患者90 Y放射栓塞后治疗结局的观察数据。

更新日期:2020-06-18
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