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CardioVascular and Interventional Radiology

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01.02.2012 | Clinical Investigation

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

verfasst von: Ralf-T. Hoffmann, Philipp M. Paprottka, Agnes Schön, Fabian Bamberg, Alexander Haug, Eva-Maria Dürr, Barbara Rauch, Christoph T. Trumm, Tobias F. Jakobs, Thomas K. Helmberger, Maximilian F. Reiser, Frank T. Kolligs

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 1/2012

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Abstract

Introduction

In unresectable intrahepatic cholangiocarcinoma (ICC), systemic chemotherapy often is viewed as the only option, although efficacy is limited. Radioembolization (RE) using yttrium-90 (⁹⁰Y) 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 ⁹⁰Y 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.

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Titel: Transarterial Hepatic Yttrium-90 Radioembolization in Patients with Unresectable Intrahepatic Cholangiocarcinoma: Factors Associated with Prolonged Survival
verfasst von: Ralf-T. Hoffmann
Philipp M. Paprottka
Agnes Schön
Fabian Bamberg
Alexander Haug
Eva-Maria Dürr
Barbara Rauch
Christoph T. Trumm
Tobias F. Jakobs
Thomas K. Helmberger
Maximilian F. Reiser
Frank T. Kolligs
Publikationsdatum: 01.02.2012
Verlag: Springer-Verlag
Erschienen in: CardioVascular and Interventional Radiology / Ausgabe 1/2012
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-011-0142-x

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