Yttrium-90 Radioembolization in Intrahepatic Cholangiocarcinoma: A Multicenter Retrospective Analysis

J Vasc Interv Radiol. 2020 Jul;31(7):1035-1043.e2. doi: 10.1016/j.jvir.2020.02.008. Epub 2020 May 28.

Abstract

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.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Bile Duct Neoplasms / diagnostic imaging
  • Bile Duct Neoplasms / mortality
  • Bile Duct Neoplasms / pathology
  • Bile Duct Neoplasms / radiotherapy*
  • Cholangiocarcinoma / diagnostic imaging
  • Cholangiocarcinoma / mortality
  • Cholangiocarcinoma / pathology
  • Cholangiocarcinoma / radiotherapy*
  • Embolization, Therapeutic* / adverse effects
  • Embolization, Therapeutic* / mortality
  • Female
  • Humans
  • Male
  • Radiopharmaceuticals / administration & dosage*
  • Radiopharmaceuticals / adverse effects
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Yttrium Radioisotopes / administration & dosage*
  • Yttrium Radioisotopes / adverse effects

Substances

  • Radiopharmaceuticals
  • Yttrium Radioisotopes