Yttrium-90 radioembolization for intrahepatic cholangiocarcinoma

Safety, response, and survival analysis

Samdeep K Mouli, Khairuddin Memon, Talia Barzel Baker, Al B Benson III, Mary Frances Mulcahy, Ramona Gupta, Robert K. Ryu, Riad Salem, Robert J Lewandowski*

*Corresponding author for this work

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Purpose: To present data on safety, antitumoral response, and survival following yttrium-90 (90Y) radioembolization for patients with unresectable intrahepatic cholangiocarcinoma (ICC). Materials and Methods: The present study expands on the cohort of 24 patients with ICC described in a pilot study, and includes 46 patients treated with 90Y radioembolization at a single institution during an 8-year period. Via retrospective review of a prospectively collected database, patients were stratified by performance status, tumor distribution (solitary or multifocal), tumor morphology (infiltrative or peripheral), and presence/absence of portal vein thrombosis. Primary endpoints included biochemical and clinical toxicities, and secondary endpoints included imaging response (World Health Organization [WHO] and European Association for the Study of Liver Disease [EASL] criteria) and survival. Uni-/multivariate analyses were performed. Results: Ninety-two treatments were performed, with a mean of two per patient. Fatigue and transient abdominal pain occurred in 25 patients (54%) and 13 patients (28%), respectively. Treatment-related gastroduodenal ulcer developed in one patient (2%). WHO imaging findings included partial response (n = 11; 25%), stable disease (n = 33; 73%), and progressive disease (n = 1; 2%). EASL imaging findings included partial/complete response (n = 33; 73%) and stable disease (n = 12; 27%). Survival varied based on presence of multifocal (5.7 mo vs 14.6 mo), infiltrative (6.1 mo vs 15.6 mo), and bilobar disease (10.9 mo vs 11.7 mo). Disease was converted to resectable status in five patients, who successfully underwent curative (ie, R0) resection. Conclusions: Radioembolization with 90Y is safe and demonstrates antitumoral response and survival benefit in select patients with ICC. Results are most pronounced in patients with solitary tumors, for whom conversion to curative resection is possible.

Original languageEnglish (US)
Pages (from-to)1227-1234
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume24
Issue number8
DOIs
StatePublished - Aug 1 2013

Fingerprint

Yttrium
Cholangiocarcinoma
Survival Analysis
Safety
Survival
Liver Diseases
Neoplasms
Portal Vein
Peptic Ulcer
Abdominal Pain
Fatigue
Thrombosis
Multivariate Analysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{a7a34111dccb4c45a254e1cc172db6f4,
title = "Yttrium-90 radioembolization for intrahepatic cholangiocarcinoma: Safety, response, and survival analysis",
abstract = "Purpose: To present data on safety, antitumoral response, and survival following yttrium-90 (90Y) radioembolization for patients with unresectable intrahepatic cholangiocarcinoma (ICC). Materials and Methods: The present study expands on the cohort of 24 patients with ICC described in a pilot study, and includes 46 patients treated with 90Y radioembolization at a single institution during an 8-year period. Via retrospective review of a prospectively collected database, patients were stratified by performance status, tumor distribution (solitary or multifocal), tumor morphology (infiltrative or peripheral), and presence/absence of portal vein thrombosis. Primary endpoints included biochemical and clinical toxicities, and secondary endpoints included imaging response (World Health Organization [WHO] and European Association for the Study of Liver Disease [EASL] criteria) and survival. Uni-/multivariate analyses were performed. Results: Ninety-two treatments were performed, with a mean of two per patient. Fatigue and transient abdominal pain occurred in 25 patients (54{\%}) and 13 patients (28{\%}), respectively. Treatment-related gastroduodenal ulcer developed in one patient (2{\%}). WHO imaging findings included partial response (n = 11; 25{\%}), stable disease (n = 33; 73{\%}), and progressive disease (n = 1; 2{\%}). EASL imaging findings included partial/complete response (n = 33; 73{\%}) and stable disease (n = 12; 27{\%}). Survival varied based on presence of multifocal (5.7 mo vs 14.6 mo), infiltrative (6.1 mo vs 15.6 mo), and bilobar disease (10.9 mo vs 11.7 mo). Disease was converted to resectable status in five patients, who successfully underwent curative (ie, R0) resection. Conclusions: Radioembolization with 90Y is safe and demonstrates antitumoral response and survival benefit in select patients with ICC. Results are most pronounced in patients with solitary tumors, for whom conversion to curative resection is possible.",
author = "Mouli, {Samdeep K} and Khairuddin Memon and Baker, {Talia Barzel} and {Benson III}, {Al B} and Mulcahy, {Mary Frances} and Ramona Gupta and Ryu, {Robert K.} and Riad Salem and Lewandowski, {Robert J}",
year = "2013",
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doi = "10.1016/j.jvir.2013.02.031",
language = "English (US)",
volume = "24",
pages = "1227--1234",
journal = "Journal of Vascular and Interventional Radiology",
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TY - JOUR

T1 - Yttrium-90 radioembolization for intrahepatic cholangiocarcinoma

T2 - Safety, response, and survival analysis

AU - Mouli, Samdeep K

AU - Memon, Khairuddin

AU - Baker, Talia Barzel

AU - Benson III, Al B

AU - Mulcahy, Mary Frances

AU - Gupta, Ramona

AU - Ryu, Robert K.

AU - Salem, Riad

AU - Lewandowski, Robert J

PY - 2013/8/1

Y1 - 2013/8/1

N2 - Purpose: To present data on safety, antitumoral response, and survival following yttrium-90 (90Y) radioembolization for patients with unresectable intrahepatic cholangiocarcinoma (ICC). Materials and Methods: The present study expands on the cohort of 24 patients with ICC described in a pilot study, and includes 46 patients treated with 90Y radioembolization at a single institution during an 8-year period. Via retrospective review of a prospectively collected database, patients were stratified by performance status, tumor distribution (solitary or multifocal), tumor morphology (infiltrative or peripheral), and presence/absence of portal vein thrombosis. Primary endpoints included biochemical and clinical toxicities, and secondary endpoints included imaging response (World Health Organization [WHO] and European Association for the Study of Liver Disease [EASL] criteria) and survival. Uni-/multivariate analyses were performed. Results: Ninety-two treatments were performed, with a mean of two per patient. Fatigue and transient abdominal pain occurred in 25 patients (54%) and 13 patients (28%), respectively. Treatment-related gastroduodenal ulcer developed in one patient (2%). WHO imaging findings included partial response (n = 11; 25%), stable disease (n = 33; 73%), and progressive disease (n = 1; 2%). EASL imaging findings included partial/complete response (n = 33; 73%) and stable disease (n = 12; 27%). Survival varied based on presence of multifocal (5.7 mo vs 14.6 mo), infiltrative (6.1 mo vs 15.6 mo), and bilobar disease (10.9 mo vs 11.7 mo). Disease was converted to resectable status in five patients, who successfully underwent curative (ie, R0) resection. Conclusions: Radioembolization with 90Y is safe and demonstrates antitumoral response and survival benefit in select patients with ICC. Results are most pronounced in patients with solitary tumors, for whom conversion to curative resection is possible.

AB - Purpose: To present data on safety, antitumoral response, and survival following yttrium-90 (90Y) radioembolization for patients with unresectable intrahepatic cholangiocarcinoma (ICC). Materials and Methods: The present study expands on the cohort of 24 patients with ICC described in a pilot study, and includes 46 patients treated with 90Y radioembolization at a single institution during an 8-year period. Via retrospective review of a prospectively collected database, patients were stratified by performance status, tumor distribution (solitary or multifocal), tumor morphology (infiltrative or peripheral), and presence/absence of portal vein thrombosis. Primary endpoints included biochemical and clinical toxicities, and secondary endpoints included imaging response (World Health Organization [WHO] and European Association for the Study of Liver Disease [EASL] criteria) and survival. Uni-/multivariate analyses were performed. Results: Ninety-two treatments were performed, with a mean of two per patient. Fatigue and transient abdominal pain occurred in 25 patients (54%) and 13 patients (28%), respectively. Treatment-related gastroduodenal ulcer developed in one patient (2%). WHO imaging findings included partial response (n = 11; 25%), stable disease (n = 33; 73%), and progressive disease (n = 1; 2%). EASL imaging findings included partial/complete response (n = 33; 73%) and stable disease (n = 12; 27%). Survival varied based on presence of multifocal (5.7 mo vs 14.6 mo), infiltrative (6.1 mo vs 15.6 mo), and bilobar disease (10.9 mo vs 11.7 mo). Disease was converted to resectable status in five patients, who successfully underwent curative (ie, R0) resection. Conclusions: Radioembolization with 90Y is safe and demonstrates antitumoral response and survival benefit in select patients with ICC. Results are most pronounced in patients with solitary tumors, for whom conversion to curative resection is possible.

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