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Yttrium-90 Radioembolization for Unresectable Standard-chemorefractory Intrahepatic Cholangiocarcinoma: Survival, Efficacy, and Safety Study

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Abstract

Purpose

To assess the overall survival, efficacy, and safety of radioembolization with yttrium-90 (Y90) for unresectable standard-chemorefractory intrahepatic cholangiocarcinoma (ICC).

Methods

Patients with unresectable standard-chemorefractory ICC treated with Y90 were studied. Survival was calculated from the date of first Y90 procedure. Tumor response was assessed with the Response Evaluation Criteria in Solid Tumors criteria on follow-up computed tomography or magnetic resonance imaging scans. National Cancer Institute Common Terminology Criteria (NCI CTCAE), version 3, were used for complications. Statistical analysis was performed by the Kaplan–Meier estimator by the log rank test.

Results

Nineteen patients underwent a total of 24 resin-based Y90 treatments. Median survival from the time of diagnosis and first Y90 procedure was 752 ± 193 [95 % confidence interval (CI) 374–1130] and 345 ± 128 (95 % CI 95–595) days, respectively. Median survival with Eastern Cooperative Oncology Group (ECOG) performance status 1 (n = 15) and ECOG performance status 2 (n = 4) was 450 ± 190 (95 % CI 78–822) and 345 ± 227 (95 % CI 0–790) days, respectively (p = .214). Patients with extrahepatic metastasis (n = 11) had a median survival of 404 ± 309 (95 % CI 0–1010) days versus 345 ± 117 (95 % CI 115–575) days for patients without metastasis (n = 8) (p = .491). No mortality was reported within 30 days from first Y90 radioembolization. One patient developed grade 3 thrombocytopenia as assessed by NCI CTCAE. Fatigue and transient abdominal pain were observed in 4 (21 %) and 6 (32 %) patients, respectively.

Conclusion

Y90 radioembolization is effective for unresectable standard-chemorefractory ICC.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Interventional Radiology and Image Guided Medicine, Department of Radiology, Emory University School of Medicine, 1364 Clifton Road NE, Suite E-118, Atlanta, GA, 30322, USA

    Shoaib Rafi, Sarat M. Piduru & Hyun S. Kim

  2. Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, 30322, USA

    Bassel El-Rayes, John S. Kauh & Hyun S. Kim

  3. Department of Surgical Oncology in Surgery, Emory University School of Medicine, Atlanta, GA, 30322, USA

    David A. Kooby, Juan M. Sarmiento & Hyun S. Kim

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  1. Shoaib Rafi
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  2. Sarat M. Piduru
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  3. Bassel El-Rayes
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  4. John S. Kauh
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  5. David A. Kooby
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  6. Juan M. Sarmiento
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  7. Hyun S. Kim
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Correspondence to Hyun S. Kim.

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Rafi, S., Piduru, S.M., El-Rayes, B. et al. Yttrium-90 Radioembolization for Unresectable Standard-chemorefractory Intrahepatic Cholangiocarcinoma: Survival, Efficacy, and Safety Study. Cardiovasc Intervent Radiol 36, 440–448 (2013). https://doi.org/10.1007/s00270-012-0463-4

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  • DOI: https://doi.org/10.1007/s00270-012-0463-4

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