Cardiovascular and interventional radiology · 2025
Long-Term Outcomes and Prognostic Factors After Yttrium-90 Resin-Based Radioembolization for Unresectable Intrahepatic Cholangiocarcinoma: A Single-Center Experience.
СтатьяНазвание и аннотация: Перевод в очереди
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Braccischi Lorenzo, Garducci Paolo Federico, Taninokuchi Tomassoni Makoto, Palloni Andrea, Zanella Sara, Della Gala Giuseppe, Strigari Lidia, Golemi Arber, Lodi Rizzini Elisa, De Cinque Antonio, Modestino Francesco, Brandi Giovanni, Mosconi Cristina
Аннотация
PURPOSE: This study aimed to evaluate the long-term efficacy, safety, and prognostic factors associated with transarterial radioembolization with yttrium-90 (Y90-TARE) in unresectable intrahepatic cholangiocarcinoma (ICC).
MATERIALS AND METHODS: We retrospectively analyzed 72 patients with unresectable ICC treated with Y90 resin microspheres TARE between 2009 and 2023. Clinical, laboratory, and imaging data were collected. Treatment response was assessed using RECIST 1.1 criteria. Primary outcome measures were overall survival (OS) and progression-free survival (PFS), evaluated through Kaplan-Meier analysis and Cox proportional hazards models. Secondary outcome measures included radiologic response and safety, with adverse events graded according to CIRSE grading system.
RESULTS: Twenty-eight of 72 (38.9%) patients had monofocal tumors, and 45/72 (62.5%) had a tumor burden < 25%. The median index tumor diameter was 6.9 cm (IQR, 3.8-8.2 cm). Median OS and PFS were 17 (95% CI 13.15-20.57) and 7.5 months (95% CI 5.00-9.50), respectively. Target lesion objective response (OR) rate was 40.3%, overall OR was 36.1%. At multivariate analysis, independent predictors of improved OS were lower tumor volume (p = 0.011), TARE as first line (p < 0.001), and selective infusion target (p = 0.012). Monolobar disease (p = 0.010) and selective infusion target (p = 0.029) emerged as independent predictors of longer PFS. TARE as first line (p = 0.062) showed a trend toward significance in multivariable model. TARE was well tolerated, with no major complications observed.
CONCLUSION: TARE is a safe and effective treatment for unresectable ICC. Selective infusion, lower tumor load, and administering TARE as first line-with or without concomitant chemotherapy-are independent predictors for prolonged OS and PFS.
MATERIALS AND METHODS: We retrospectively analyzed 72 patients with unresectable ICC treated with Y90 resin microspheres TARE between 2009 and 2023. Clinical, laboratory, and imaging data were collected. Treatment response was assessed using RECIST 1.1 criteria. Primary outcome measures were overall survival (OS) and progression-free survival (PFS), evaluated through Kaplan-Meier analysis and Cox proportional hazards models. Secondary outcome measures included radiologic response and safety, with adverse events graded according to CIRSE grading system.
RESULTS: Twenty-eight of 72 (38.9%) patients had monofocal tumors, and 45/72 (62.5%) had a tumor burden < 25%. The median index tumor diameter was 6.9 cm (IQR, 3.8-8.2 cm). Median OS and PFS were 17 (95% CI 13.15-20.57) and 7.5 months (95% CI 5.00-9.50), respectively. Target lesion objective response (OR) rate was 40.3%, overall OR was 36.1%. At multivariate analysis, independent predictors of improved OS were lower tumor volume (p = 0.011), TARE as first line (p < 0.001), and selective infusion target (p = 0.012). Monolobar disease (p = 0.010) and selective infusion target (p = 0.029) emerged as independent predictors of longer PFS. TARE as first line (p = 0.062) showed a trend toward significance in multivariable model. TARE was well tolerated, with no major complications observed.
CONCLUSION: TARE is a safe and effective treatment for unresectable ICC. Selective infusion, lower tumor load, and administering TARE as first line-with or without concomitant chemotherapy-are independent predictors for prolonged OS and PFS.