Yttrium-90 Radioembolization for Intrahepatic Cholangiocarcinoma: Safety, Response, and Survival Analysis

Mouli, S.; Memon, Khairuddin; Baker, Talia; Benson, Al B.; Mulcahy, Mary F.; Gupta, Ramona; Ryu, Robert K.; Salem, Riad; Lewandowski, Robert J.

doi:10.1016/j.jvir.2013.02.031

Cited by 191 publications

(148 citation statements)

References 29 publications

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“…However, the prevalence of AE in this patient population was higher than previously reported in studies of patients with hepatic metastases (21,22) or cholangiocarcinoma (16) who were treated with glass microspheres. For instance, Sato et al (21) reported on prospectively acquired data for 137 patients treated with 90 Y glass microspheres for hepatic metastases from a variety of sources.…”

Section: Discussioncontrasting

confidence: 73%

“…The reported rate of gastrointestinal ulcer formation following radioembolization using 90 Y glass microspheres is 0-2% in large series (16,21,22). However, 90 Y glass microsphere-induced ulcers may be refractory to medical management (16), as described in this study.…”

Section: Discussionmentioning

confidence: 61%

“…Radioembolization involves transcatheter arterial delivery of 20-60 mm microspheres containing Yttrium-90 ( 90 Y) radioisotope into the tumor microvasculature (5). S t u d i e s d o c u m e n t i n g s a f e t y a n d e f f i c a c y o f radioembolization for hepatic metastases from colorectal (CRC) (6)(7)(8), neuroendocrine tumors (NET) (9)(10)(11)(12), and intrahepatic cholangiocarcinoma (13)(14)(15)(16)(17) largely represent retrospective case series. However, there has also been a growing number of prospective studies documenting the use of radioembolization for treatment of metastatic CRC (18)(19)(20) and describing the use of 90 Y glass microspheres for patients with hepatic metastases from a variety of tumor types (21,22).…”

Section: Introductionmentioning

confidence: 99%

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Radioembolization with 490Y glass microspheres for the treatment of unresectable metastatic liver disease from chemotherapy-refractory gastrointestinal cancers: final report of a prospective pilot study

Fidelman

Kerlan

Taylor

et al. 2015

Journal of Vascular and Interventional Radiology

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Background: This prospective pilot single-institution study was undertaken to document the feasibility, Majority of clinical AE were grade 1 or 2 in severity. Patients with colorectal cancer had hepatic objective response rate (ORR) of 25% and a hepatic disease control rate (DCR) of 80%. Median PFS and OS were 1.0 and 4.4 months, respectively. Patients with neuroendocrine tumors (NET) had hepatic ORR and DCR of 73% and 100%, respectively. Median PFS was 8.9 months for this cohort. DCR and median PFS and OS for patients with cholangiocarcinoma were 86%, 1.1 months, and 6.7 months, respectively. Conclusions: 90 Y glass microspheres device has a favorable safety profile, and achieved prolonged disease control of hepatic tumor burden in a subset of patients, including all patients enrolled in the neuroendocrine cohort.

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Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 61%

Section: Introductionmentioning

confidence: 99%

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Radioembolization with 490Y glass microspheres for the treatment of unresectable metastatic liver disease from chemotherapy-refractory gastrointestinal cancers: final report of a prospective pilot study

Fidelman

Kerlan

Taylor

et al. 2015

Journal of Vascular and Interventional Radiology

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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%

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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“…It may be employed for the treatment of intrahepatic CCA and has appeared to confer survival benefits to patients. Radioembolization has also been reported to transform unresectable into resectable tumors (43,44). Therefore, the effectiveness of this approach for treating intrahepatic CCA should also be further investigated.…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of cholangiocarcinoma patients receiving adjuvant radiotherapy

Nantajit

Trirussapanich

Rojwatkarnjana

et al. 2016

Molecular and Clinical Oncology

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Abstract. Cholangiocarcinoma (CCA) or bile duct cancer is a rare cancer type in developed countries, while its prevalence is increased in southeast Asia, affecting ~33.4 men and ~12.3 women per 100,000 individuals. CCA is one of the most lethal types of cancer. Neo-adjuvant and adjuvant therapies have been shown to have limited efficacy in improving the overall prognosis of patients. Radiotherapy has been reported to prolong the survival times of patients with certain characteristics. The present study retrospectively evaluated the medical records and follow-up data from 27 CCA patients who received radiotherapy at Chulabhorn Hospital (Bangkok, Thailand) between 2008 and 2014. A total of 14 patients underwent surgery followed by adjuvant chemoradiotherapy. Of the 27 CCA patients, 14 had intrahepatic CCA, 2 had extrahepatic CCA and 11 had hilar CCA. The 2-year survival rate was 40.7%. Tumor resectability, clinical symptoms and the Eastern Cooperative Oncology Group performance status score were found to be indicative of patient prognosis. In addition, the planning target volume and biologically effective radiotherapy dose were of prognostic value; however, initial treatment response was ambiguous in predicting survival time. The findings of the present study suggested that the currently used radiotherapy protocols for CCA may require modification to improve their efficacy.

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Yttrium-90 Radioembolization for Intrahepatic Cholangiocarcinoma: Safety, Response, and Survival Analysis

Cited by 191 publications

References 29 publications

Radioembolization with 490Y glass microspheres for the treatment of unresectable metastatic liver disease from chemotherapy-refractory gastrointestinal cancers: final report of a prospective pilot study

Radioembolization with 490Y glass microspheres for the treatment of unresectable metastatic liver disease from chemotherapy-refractory gastrointestinal cancers: final report of a prospective pilot study

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

Clinical analysis of cholangiocarcinoma patients receiving adjuvant radiotherapy

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