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钇-90放射性栓塞治疗不可切除肝内胆管癌患者总生存的预后因素:初治患者的结果

Prognostic Factors in Overall Survival of Patients with Unresectable Intrahepatic Cholangiocarcinoma Treated by Means of Yttrium-90 Radioembolization: Results in Therapy-Naïve Patients.

作者信息

Reimer P, Virarkar M K, Binnenhei M, Justinger M, Schön M R, Tatsch K

机构信息

Institute for Diagnostic and Interventional Radiology, Klinikum Karlsruhe, Academic Teaching Hospital of the University of Freiburg, Moltkestraße 90, 76133, Karlsruhe, Germany.

Department of Diagnostic Radiology, M D Anderson Cancer Center, Houston, TX, USA.

出版信息

Cardiovasc Intervent Radiol. 2018 May;41(5):744-752. doi: 10.1007/s00270-017-1871-2. Epub 2018 Jan 17.

Abstract

INTRODUCTION

To investigate prognostic factors in unresectable intrahepatic cholangiocarcinoma (ICC) therapy-naïve patients after yttrium-90 (Y-90) radioembolization (RE) therapy.

MATERIALS AND METHODS

Between 2005 and 2016, 21 patients with ICC were treated with Y-90 RE only and their survival data were analyzed. Patients were stratified and response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria.

RESULT

The overall median survival was 15 months. Survival was significantly (p = 0.009) prolonged in patients with tumor burden of ≤ 25% (n = 8, OS 37.5 months) versus those with a tumor burden of 25-50% (n = 13, OS 15 months). The other variables: tumor morphology (infiltrative vs. peripheral), tumor distribution (solitary vs. multifocal), lobes involved (unilobar vs. bilobar), FDG PET status (FDG avid vs. non-avid), RE treatment sessions (1 session vs. 2 sessions), metastases (metastasis vs. no metastasis) and RECIST criteria, had no significant impact on survival.

CONCLUSION

Tumor burden represents a key prognostic factor of survival in therapy-naïve patients with unresectable ICC treated with Y-90 RE therapy only.

摘要

引言

研究初治的无法切除的肝内胆管癌(ICC)患者在接受钇-90(Y-90)放射性栓塞(RE)治疗后的预后因素。

材料与方法

2005年至2016年间,21例ICC患者仅接受了Y-90 RE治疗,并对其生存数据进行了分析。对患者进行分层,并根据实体瘤疗效评价标准(RECIST)评估反应。

结果

总体中位生存期为15个月。肿瘤负荷≤25%的患者(n = 8,总生存期37.5个月)与肿瘤负荷为25%-50%的患者(n = 13,总生存期15个月)相比,生存期显著延长(p = 0.009)。其他变量:肿瘤形态(浸润性与周边性)、肿瘤分布(孤立性与多灶性)、累及叶(单叶与双叶)、氟代脱氧葡萄糖正电子发射断层显像(FDG PET)状态(FDG摄取阳性与阴性)、RE治疗次数(1次与2次)、转移情况(有转移与无转移)以及RECIST标准,对生存期均无显著影响。

结论

肿瘤负荷是仅接受Y-90 RE治疗的初治无法切除ICC患者生存的关键预后因素。

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