Intra-arterial Yttrium-90 Radioembolization Combined with Systemic Chemotherapy is a Promising Method for Downstaging Unresectable Huge Intrahepatic Cholangiocarcinoma to Surgical Treatment

Rayar, Michel; Sulpice, Laurent; Edeline, Julien; Garin, Étienne; Sandri, Giovanni Battista Levi; Meunier, Brigitte; Boucher, Éveline; Boudjéma, Karim

doi:10.1245/s10434-014-4365-3

Cited by 115 publications

(74 citation statements)

References 35 publications

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“…Downstaging occurs in 10%, and inducing contralateral hypertrophy seems feasible (65,72). In a small cohort combining radioembolization with chemotherapy, downstaging occurred in 22%, significant hypertrophy of the contralateral lobes was seen in all patients, and 18% were radically resected (74). In general, these results for intrahepatic cholangiocarcinoma are promising, but current literature is limited.…”

Section: Clinical Outcome and Tumor Responsementioning

confidence: 99%

⁹⁰Y Hepatic Radioembolization: An Update on Current Practice and Recent Developments

et al. 2015

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Learning Objectives: On successful completion of this activity, participants should be able to (1) describe the status of the current literature regarding new indications for radioembolization; (2) describe standard hepatic vascularization, identify common routes for extrahepatic depositions, and judge when "skeletization" of hepatic arteries could be unnecessary; and (3) appraise the different methods of activity calculation and recognize the strengths and pitfalls of pretreatment and posttreatment dosimetry.Financial Disclosure: Dr. Lam is a consultant/advisor for BTG International and a meeting participant/lecturer for SirTex Medical. The authors of this article have indicated no other relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through July 2018.Radioembolization is an established treatment modality that has been subjected to many improvements over the last decade. Developments are occurring at a high pace, affecting patient selection and treatment. The aim of this review is therefore to provide an overview of current practice, with a focus on recent developments in the field of radioembolization. Several practical issues and recommendations in the application of radioembolization will be discussed, ranging from patient selection to treatment response and future applications.

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Section: Clinical Outcome and Tumor Responsementioning

confidence: 99%

⁹⁰Y Hepatic Radioembolization: An Update on Current Practice and Recent Developments

et al. 2015

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“…In patients with advanced BCLC stage, Y90-RE treatment has superior results compared with trans-arterial chemo embolization (TACE) (32). Y90-RE was first of all described as an alternative option for non-resectable liver tumors (7,21,(33)(34)(35). Accordingly in selected patients, Y90-RE is considered an effective tool for the downstaging strategy (36,37).…”

Section: Discussionmentioning

confidence: 99%

Trans-arterial radio-embolization: a new chance for patients with hepatocellular cancer to access liver transplantation, a world review

Sandri

Ettorre

Giannelli

et al. 2017

Transl. Gastroenterol. Hepatol.

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Liver transplantation (LT) for hepatocellular carcinoma (HCC) within the Milan criteria (MC)is nowadays a curative procedure. Yttrium-90 microspheres radioembolization (Y90-RE) has shown to be an effective and safe treatment of primary liver tumors. The aim of this work is to offer a view on the publications which report on the use of Y90-RE as bridge or downstaging prior to LT. Twenty articles have been considered for this world review. About 178 LT in patients were treated with Y90-RE prior to LT. Most of patients had a downstaging strategy. In all series alpha-fetoproteins decreased between Y90-RE and LT.Therefore, Y90-RE may have an important role in the bridge and downstaging treatments.

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“…Its interest in the palliative treatment of ICC has been demonstrated [7,18,19] and our team recently reported its utility for downstaging huge initially unresectable lesions, thereby enabling secondary resection [8].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, we showed its interest in downstaging huge and unresectable ICCs which enabled secondary resection [8].…”

Section: Introductionmentioning

confidence: 99%

Multimodal Therapy including Yttrium-90 Radioembolization as a Bridging Therapy to Liver Transplantation for a Huge and Locally Advanced Intrahepatic Cholangiocarcinoma

Rayar

Sandri

Houssel‐Debry

et al. 2016

JGLD

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Treatment of intrahepatic cholangiocarcinoma remains a major challenge. For an unresectable lesion without extrahepatic spread, liver transplantation could be a potential solution but it is still associated with poor oncologic results owing to the absence of effective neoadjuvant treatment. We report the case of a young man with locally advanced intrahepatic cholangiocarcinoma presenting with multiple intrahepatic metastases and vascular structure involvement. The lesion was significantly downstaged by a multimodal therapy including intra-arterial Yttrium-90 radioembolization, systemic chemotherapy and external radiotherapy, allowing liver transplantation. Three years after the procedure, oncologic outcome is excellent with no sign of recurrence.Multimodal therapy including Yttrium-90 radioembolization could be relevant as neoadjuvant treatment before liver transplantation for unresectable intrahepatic cholangiocarcinoma. Abbrevations: CA 19-9: carbohydrate antigen 19-9; FDG-PET: fluorodeoxyglucose positron emission tomography; HCC: hepatocellular carcinoma; ICC: intrahepatic cholangiocarcinoma; LT: liver transplantation; MRI: magnetic resonance imaging; PHC: perihilar cholangiocarcinoma; Ytt-90: Yttrium-90.

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Intra-arterial Yttrium-90 Radioembolization Combined with Systemic Chemotherapy is a Promising Method for Downstaging Unresectable Huge Intrahepatic Cholangiocarcinoma to Surgical Treatment

Abstract: For initially unresectable huge ICCs, chemotherapy with Ytt-90 radioembolization is an effective downstaging method that allows for secondary resectability.

Cited by 115 publications

References 35 publications

⁹⁰Y Hepatic Radioembolization: An Update on Current Practice and Recent Developments

⁹⁰Y Hepatic Radioembolization: An Update on Current Practice and Recent Developments

Trans-arterial radio-embolization: a new chance for patients with hepatocellular cancer to access liver transplantation, a world review

Multimodal Therapy including Yttrium-90 Radioembolization as a Bridging Therapy to Liver Transplantation for a Huge and Locally Advanced Intrahepatic Cholangiocarcinoma

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Intra-arterial Yttrium-90 Radioembolization Combined with Systemic Chemotherapy is a Promising Method for Downstaging Unresectable Huge Intrahepatic Cholangiocarcinoma to Surgical Treatment

Abstract: For initially unresectable huge ICCs, chemotherapy with Ytt-90 radioembolization is an effective downstaging method that allows for secondary resectability.

Cited by 115 publications

References 35 publications

90Y Hepatic Radioembolization: An Update on Current Practice and Recent Developments

90Y Hepatic Radioembolization: An Update on Current Practice and Recent Developments

Trans-arterial radio-embolization: a new chance for patients with hepatocellular cancer to access liver transplantation, a world review

Multimodal Therapy including Yttrium-90 Radioembolization as a Bridging Therapy to Liver Transplantation for a Huge and Locally Advanced Intrahepatic Cholangiocarcinoma

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⁹⁰Y Hepatic Radioembolization: An Update on Current Practice and Recent Developments

⁹⁰Y Hepatic Radioembolization: An Update on Current Practice and Recent Developments