Transarterial Hepatic Yttrium-90 Radioembolization in Patients with Unresectable Intrahepatic Cholangiocarcinoma: Factors Associated with Prolonged Survival

Abstract

Radioembolization is an effective and safe option for patients with unresectable ICC. Predictors for prolonged survival are performance status, tumor burden, and RECIST response.

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

“…However, the short untreated liver lobe and extrahepatic PFS we observed suggest that 90 Y radioembolization may be more beneficial earlier in the course of the disease, in combination with standard chemotherapy, or if used as a "bridge" between two standard chemotherapy regimens. Patients with cholangiocarcinoma had hepatic DCR of 86%, which was similar to previously reported DCR of 72-98% (14)(15)(16)(17). However, median OS of 6.7 months reported in this study was lower than previously described range of 9.3-22 months.…”

“…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).…”

Safety of Radioembolization with 90Yttrium Resin Microspheres Depending on Coiling or No-Coiling of Aberrant/High-Risk Vessels

“…There is a lot of data existing about the effectiveness of radioembolization therapy in patients suffering from hepatocellular carcinoma [6,26] and intrahepatic cholangiocarcinoma [8] as well as patients with unresectable liver metastases of colorectal cancer [9,27], breast carcinoma [7,23], pancreatic carcinoma [21], and neuroendocrine tumors [8,13,31].…”

“…Hepatic malignancies receive their blood supply mainly from the hepatic artery, whereas the normal liver parenchyma is perfused predominantly from the portal-venous circulation [3]. Accordingly, a high-dose delivery to the tumor vasculature with relative sparing of normal liver tissue can be achieved, which has shown to be effective for primary and metastatic liver tumors [8,10,11,14,18,31].…”

Two Cases of Unresectable Cholangiocarcinoma Treated by Yttrium-90 Microspheres

“…2C), we implanted 0. Those studies showed mean survival duration of 14.9, 9.3 and 10 months, respectively, without significant toxicities (11)(12)(13). …”