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Radioembolization with Yttrium-90 Glass Microspheres as a First-Line Treatment for Unresectable Intrahepatic Cholangiocarcinoma-A Prospective Feasibility Study.
- Source :
-
Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2023 Sep; Vol. 34 (9), pp. 1547-1555. Date of Electronic Publication: 2023 May 18. - Publication Year :
- 2023
-
Abstract
- Purpose: To evaluate the safety and effectiveness of yttrium-90 ( <superscript>90</superscript> Y) radioembolization as first-line treatment for unresectable intrahepatic cholangiocarcinoma (ICC).<br />Materials and Methods: This prospective study enrolled patients who had never received chemotherapy, liver embolization, and radiation therapy. The tumors were solitary in 16 patients, multiple in 8 patients, unilobar in 14 patients, and bilobar in 10 patients. Patients underwent transarterial radioembolization with <superscript>90</superscript> Y-labeled glass microspheres. The primary end point was hepatic progression-free survival (HPFS). Secondary end points were overall survival (OS), tumor response, and toxicity.<br />Results: Twenty-four patients (age, 72.3 years ± 9.3; 12 women) were included in the study. The median delivered radiation dose was 135.5 Gy (interquartile range, 77.6 Gy). The median HPFS was 5.5 months (95% CI, 3.9-7.0 months). Analysis failed to identify any prognostic factor associated with HPFS. Imaging response at 3 months showed 56% disease control, and the best radiographic response was 71% disease control. The median OS from the radioembolization treatment was 19.4 months (95% CI, 5.0-33.7). Patients with solitary ICC had significantly longer median OS than patients with multifocal ICC: 25.9 months (95% CI, 20.8-31.0 months) versus 10.7 months (95% CI, 8.0-13.4 months) (P = .02). Patients with progression on the 3-month imaging follow-up had significantly shorter median OS than patients who had stable disease at 3 months: 10.7 months (95% CI, 0.7-20.7 months) versus 37.3 months (95% CI, 16.5-58.1 months) (P = .003). Two (8%) Grade 3 toxicities were reported.<br />Conclusions: First-line treatment of ICC with radioembolization showed promising OS and minimal toxicity, especially in patients with solitary tumor. Radioembolization may be considered as a first-line treatment option for unresectable ICC.<br /> (Copyright © 2023 SIR. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Female
Aged
Prospective Studies
Bile Ducts, Intrahepatic
Microspheres
Feasibility Studies
Treatment Outcome
Yttrium Radioisotopes
Cholangiocarcinoma diagnostic imaging
Cholangiocarcinoma radiotherapy
Embolization, Therapeutic methods
Bile Duct Neoplasms diagnostic imaging
Bile Duct Neoplasms radiotherapy
Liver Neoplasms diagnostic imaging
Liver Neoplasms radiotherapy
Subjects
Details
- Language :
- English
- ISSN :
- 1535-7732
- Volume :
- 34
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of vascular and interventional radiology : JVIR
- Publication Type :
- Academic Journal
- Accession number :
- 37210030
- Full Text :
- https://doi.org/10.1016/j.jvir.2023.05.026