Yttrium-90 Radioembolization in Intrahepatic Cholangiocarcinoma: A Multicenter Retrospective Analysis.,Journal of Vascular and Interventional Radiology

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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

Department of Surgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Room E.01.1.29, Internal Mail E01.132, P.O. 85500, 3508 GA Utrecht, The Netherlands.
Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
Department of Interventional Radiology, Vanderbilt University Medical Center, Nashville, Tennessee.
Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Medical Oncology, The Christie National Health Service Foundation Trust, Manchester, United Kingdom; Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom.
Department of Radiology, The Christie National Health Service Foundation Trust, Manchester, United Kingdom.
Departments of Surgery, University Medical Center Utrecht, Room E.01.1.29, Internal Mail E01.132, P.O. 85500, 3508 GA Utrecht, The Netherlands.
Department of Interventional Radiology, Stanford University Medical Center, Stanford, California.

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％）。