Yttrium-90 Radioembolization in Unresectable Intrahepatic Cholangiocarcinoma: Results of a Multicenter Retrospective Study
| Autor: | Rita Golfieri, Irene Bargellini, Gianluca Masi, Giulio Vallati, Giuseppe Boni, Rosa Sciuto, Alberta Cappelli, Caterina Vivaldi, Roberto Cioni, Giulia Lorenzoni, Cristina Mosconi, Federico Cappelli, Giuseppe Pizzi, Andrea Paladini |
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| Přispěvatelé: | Bargellini I., Mosconi C., Pizzi G., Lorenzoni G., Vivaldi C., Cappelli A., Vallati G.E., Boni G., Cappelli F., Paladini A., Sciuto R., Masi G., Golfieri R., Cioni R. |
| Rok vydání: | 2020 |
| Předmět: |
Male
Yttrium-90 medicine.medical_specialty Multivariate analysis Survival medicine.medical_treatment Group A Gastroenterology Group B 030218 nuclear medicine & medical imaging Cholangiocarcinoma Intrahepatic cholangiocarcinoma Therapeutic embolization 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Yttrium Radioisotopes Radiology Nuclear Medicine and imaging Objective response Intrahepatic Cholangiocarcinoma Aged Neoplasm Staging Retrospective Studies Chemotherapy business.industry Retrospective cohort study Middle Aged Embolization Therapeutic Bile Ducts Intrahepatic Treatment Outcome Bile Duct Neoplasms Radiological weapon Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | CardioVascular and Interventional Radiology. 43:1305-1314 |
| ISSN: | 1432-086X 0174-1551 |
| Popis: | Background: Y90 transarterial radioembolization (Y90-RE) may improve clinical outcomes of unresectable intrahepatic cholangiocarcinoma (ICC); however, the optimal timing for Y90-RE is still debated. The purpose of this multicenter study was to retrospectively evaluate clinical outcomes of RE in patients with unresectable ICC, comparing three different settings: chemotherapy naïve patients (group A), patients with disease control after first-line chemotherapy (group B) and patients with progression after first-line chemotherapy (group C). Materials and Methods: The study included 81 consecutive patients (49 male, mean age 62.4 ± 11.8years): 35 (43.2%) patients were in group A, 19 (23.5%) in group B, and 27 (33.3%) in group C. Preprocedural clinical variables, tumour response according to RECIST 1.1 and overall survival (OS) were analysed and compared. Results: Baseline demographic and clinical features did not differ significantly among groups, with the exception of prior surgical procedures that were significantly higher in group C patients, and macrovascular invasion that was more frequent in group B. Radiological response was available in 79 patients; objective response and disease control rates were 41.8% and 83.6%, respectively, without significant differences among groups. Median OS was 14.5months (95% CI: 11.1–16.9) and was not significantly different among treatment groups. At multivariate analysis, tumour burden > 50%, neutrophil-to-lymphocyte (N/L) ratio ≥ 3 and radiological progression as best response resulted to be significant (P < 0.05) independent factors, negatively associated with OS. Conclusion: Y90-RE is a valuable treatment option in unresectable ICC, irrespectively from the timing of treatment. Tumour extension, N/L ratio and radiological response affect post-treatment survival. |
| Databáze: | OpenAIRE |
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