Transarterial hepatic yttrium-90 radioembolization in patients with unresectable intrahepatic cholangiocarcinoma: factors associated with prolonged survival

Autor: Barbara Rauch, Ralf-T. Hoffmann, Frank T. Kolligs, Maximilian F. Reiser, Eva-Maria Dürr, Thomas Helmberger, Christoph Trumm, Tobias F. Jakobs, Fabian Bamberg, Philipp M. Paprottka, Agnes Schön, Alexander Haug
Rok vydání: 2010
Předmět:
Male
medicine.medical_specialty
SIR-Spheres
CA-19-9 Antigen
medicine.medical_treatment
Bile Duct Neoplasm
Gastroenterology
Cholangiocarcinoma
Liver Function Tests
Internal medicine
medicine
Biomarkers
Tumor
Humans
Radiology
Nuclear Medicine and imaging
Yttrium Radioisotopes
Embolization
Survival rate
Intrahepatic Cholangiocarcinoma
Aged
Retrospective Studies
Aged
80 and over
Tomography
Emission-Computed
Single-Photon
Chemotherapy
medicine.diagnostic_test
business.industry
Liver Neoplasms
Angiography
Retrospective cohort study
Middle Aged
Embolization
Therapeutic
Magnetic Resonance Imaging
Microspheres
Survival Rate
Bile Ducts
Intrahepatic
Treatment Outcome
Bile Duct Neoplasms
Fluoroscopy
Disease Progression
Female
Cardiology and Cardiovascular Medicine
Liver function tests
business
Tomography
X-Ray Computed
Zdroj: Cardiovascular and interventional radiology. 35(1)
ISSN: 1432-086X
Popis: In unresectable intrahepatic cholangiocarcinoma (ICC), systemic chemotherapy often is viewed as the only option, although efficacy is limited. Radioembolization (RE) using yttrium-90 ((90)Y) microspheres is an accepted therapy for patients with hepatocellular-carcinoma or metastatic liver tumors. However, there are limited data on the value of RE in patients with ICC and few data on factors influencing prognosis. The purpose of our retrospective analysis was to establish which factors influenced time-to-progression (TTP) and overall survival (OS).Patients with unresectable ICC were treated with (90)Y resin-microspheres and assessed at 3-monthly intervals. Radiologic response was evaluated by using Response Criteria in Solid Tumors (RECIST). Baseline characteristics, biochemical/clinical toxicities, and response were examined for impact on TTP and OS.Thirty-four treatments were administered to 33 patients without major complications. By RECIST, 12 patients had a partial response, 17 had stable disease, and 5 had progressive disease after 3 months. The median OS was 22 months posttreatment and 43.7 months postdiagnosis. Median TTP was 9.8 months. Survival and TTP were significantly prolonged in patients with ECOG 0 (vs. ECOG 1 or 2; median OS: 29.4, 10, and 5.1 months; TTP: 17.5, 6.9, and 2.4 months), tumor burden ≤25% (OS: 26.7 vs. 6 months; TTP: 17.5 vs. 2.3 months), or tumor response (PR or SD vs. PD; OS: 35.5, 17.7 vs. 5.7 months; TTP: 31.9, 9.8 vs. 2.5 months), respectively (P 0.001).Radioembolization is an effective and safe option for patients with unresectable ICC. Predictors for prolonged survival are performance status, tumor burden, and RECIST response.
Databáze: OpenAIRE
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