No abstract

Purpose: To report outcomes of yttrium-90 ( 90 Y) 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 c 2 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 ¼ .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 ¼ .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 ¼ .730 and P ¼ .475, respectively). Five patients were able to undergo curative-intent resection after 90 Y radioembolization (4%). Conclusions:This study provides observational data of treatment outcomes after 90 Y radioembolization in patients with unresectable ICC.

No abstract

Purpose: To evaluate the safety and efficacy of yttrium-90 transarterial radioembolization (TARE) for the treatment of unresectable, chemotherapy-refractory intrahepatic cholangiocarcinoma (ICC).Methods: A prospective, observational study was carried out in 10 centers between 2013 and 2017. TARE plus standard care was delivered to patients with unresectable, chemotherapy-refractory or chemotherapy-intolerant ICC. Primary outcome was overall survival. Secondary outcomes included safety, progression-free survival (PFS), and liver-specific progression-free survival (LPFS).Results: Sixty-one patients were treated with TARE. Patients were 53% male; median age was 64 years; 91% had performance status 0/1; 92% had received prior chemotherapy; and 59% had no extrahepatic disease. Median follow-up was 13.9 months (95% confidence interval [CI], 9.6-18.1). Overall survival was 8.7 months (95% CI, 5.3-12.1), and 37% of patients survived to 12 months. PFS was 2.8 months (95% CI, 2.6-3.1), and LPFS was 3.1 months (95% CI, 1.3-4.8). One severe complication (abdominal pain) occurred at the time of the TARE procedure. Thirty patients experienced a total of 49 adverse events, of which 8% were grade 3; most common were grade 1-2 fatigue and abdominal pain. A total of 77 abnormal laboratory value events were recorded, of which 4% were grade 3. Conclusions:Patients with advanced ICC have limited therapeutic options and a poor prognosis. This prospective study examined the survival of patients with unresectable, chemotherapy-refractory primary ICC treated with TARE in real-world practice. The results demonstrate that this treatment merits further investigation in this patient cohort in a larger study, including collection of patient-reported outcomes. ABBREVIATIONSAE ¼ adverse event, CI ¼ confidence interval, ICC ¼ intrahepatic cholangiocarcinoma, IQR ¼ interquartile range, LPFS ¼ liverspecific progression-free survival, OS ¼ overall survival, PET ¼ positron emission tomography, PFS ¼ progression-free survival, RECIST ¼ Response Evaluation Criteria in Solid Tumors, SD ¼ stable disease, TARE ¼ transarterial radioembolization