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.
Cardiovasc Intervent Radiol. 2013 Apr;36(2):440-8. doi: 10.1007/s00270-012-0463-4. Epub 2012 Sep 7.
To assess the overall survival, efficacy, and safety of radioembolization with yttrium-90 (Y90) for unresectable standard-chemorefractory intrahepatic cholangiocarcinoma (ICC).
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.
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.
Y90 radioembolization is effective for unresectable standard-chemorefractory ICC.
评估钇-90（Y90）放射性栓塞治疗不可切除标准化疗耐药性肝内胆管癌（ICC）的总生存率、疗效和安全性。
研究了接受 Y90 放射性栓塞治疗的不可切除标准化疗耐药性 ICC 患者。从首次 Y90 治疗之日起计算生存时间。采用实体瘤反应评价标准（Response Evaluation Criteria in Solid Tumors，RECIST）评估随访 CT 或磁共振成像扫描的肿瘤反应。采用美国国立癌症研究所常见不良事件术语标准（National Cancer Institute Common Terminology Criteria，NCI CTCAE），版本 3，评估并发症。通过对数秩检验的 Kaplan-Meier 估计器进行统计分析。
19 名患者共接受了 24 次树脂基 Y90 治疗。从诊断和首次 Y90 治疗开始的中位生存时间分别为 752±193 天（95%置信区间 [CI]：374-1130）和 345±128 天（95%CI：95-595）。ECOG 表现状态 1（n=15）和 ECOG 表现状态 2（n=4）的中位生存时间分别为 450±190 天（95%CI：78-822）和 345±227 天（95%CI：0-790）（p=0.214）。有肝外转移（n=11）的患者中位生存时间为 404±309 天（95%CI：0-1010），而无转移（n=8）的患者中位生存时间为 345±117 天（95%CI：115-575）（p=0.491）。首次 Y90 放射性栓塞治疗后 30 天内无死亡报告。1 例患者根据 NCI CTCAE 评估发生 3 级血小板减少症。4（21%）例患者出现乏力，6（32%）例患者出现短暂性腹痛。
Y90 放射性栓塞治疗不可切除标准化疗耐药性 ICC 是有效的。
