Buettner Stefan, Braat Arthur J A T, Margonis Georgios Antonios, Brown Daniel B, Taylor Kevin B, Borgmann Anthony J, Kappadath S Cheenu, Mahvash Armeen, IJzermans Jan N M, Weiss Matthew J, Lamarca Angela, Bell Jon K, Valle Juan W, Hagendoorn Jeroen, Koerkamp Bas Groot, Sze Daniel Y, Lam Marnix G E H
Department of Surgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Room E.01.1.29, Internal Mail E01.132, P.O. 85500, 3508 GA Utrecht, The Netherlands.
J Vasc Interv Radiol. 2020 Jul;31(7):1035-1043.e2. doi: 10.1016/j.jvir.2020.02.008. Epub 2020 May 28.
To report outcomes of yttrium-90 (Y) radioembolization in patients with unresectable intrahepatic cholangiocarcinoma (ICC).
Retrospective review was performed of 115 patients at 6 tertiary care centers; 92 were treated with resin microspheres (80%), 22 were treated with glass microspheres (19%), and 1 was treated with both. Postintervention outcomes were compared between groups with χ tests. Survival after diagnosis and after treatment was assessed by Kaplan-Meier method.
Grade 3 laboratory toxicity was observed in 4 patients (4%); no difference in toxicity profile between resin and glass microspheres was observed (P = .350). Clinical toxicity per Society of Interventional Radiology criteria was noted in 29 patients (25%). Partial response per Response Evaluation Criteria In Solid Tumors 1.1 was noted in 25% of patients who underwent embolization with glass microspheres and 3% of patients who were treated with resin microspheres (P = .008). Median overall survival (OS) from first diagnosis was 29 months (95% confidence interval [CI], 21-37 mo) for all patients, and 1-, 3-, and 5-year OS rates were 85%, 31%, and 8%, respectively. Median OS after treatment was 11 months (95% CI, 8-13 mo), and 1- and 3-year OS rates were 44% and 4%, respectively. These estimates were not significantly different between resin and glass microspheres (P = .730 and P = .475, respectively). Five patients were able to undergo curative-intent resection after Y radioembolization (4%).
This study provides observational data of treatment outcomes after Y radioembolization in patients with unresectable ICC.
报告钇-90（Y）放射性栓塞治疗不可切除性肝内胆管癌（ICC）患者的疗效。
对6家三级医疗中心的115例患者进行回顾性研究；92例接受树脂微球治疗（80%），22例接受玻璃微球治疗（19%），1例同时接受两种微球治疗。采用χ检验比较各治疗组的干预后结果。采用Kaplan-Meier法评估诊断后和治疗后的生存率。
4例患者（4%）出现3级实验室毒性反应；树脂微球和玻璃微球之间的毒性特征无差异（P = 0.350）。根据介入放射学会标准，29例患者（25%）出现临床毒性反应。根据实体瘤疗效评价标准1.1，接受玻璃微球栓塞治疗的患者中25%出现部分缓解，接受树脂微球治疗的患者中3%出现部分缓解（P = 0.008）。所有患者自首次诊断后的中位总生存期（OS）为29个月（95%置信区间[CI]，21 - 37个月），1年、3年和5年OS率分别为85%、31%和8%。治疗后的中位OS为11个月（95% CI，8 - 13个月），1年和3年OS率分别为44%和4%。树脂微球和玻璃微球之间的这些估计值无显著差异（分别为P = 0.730和P = 0.475）。5例患者（4%）在Y放射性栓塞治疗后能够接受根治性切除。
本研究提供了Y放射性栓塞治疗不可切除性ICC患者后治疗结果的观察性数据。
