Yttrium-90 Radioembolization in Unresectable Intrahepatic Cholangiocarcinoma: Results of a Multicenter Retrospective Stu
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CLINICAL INVESTIGATION
INTERVENTIONAL ONCOLOGY
Yttrium-90 Radioembolization in Unresectable Intrahepatic Cholangiocarcinoma: Results of a Multicenter Retrospective Study Irene Bargellini1 • Cristina Mosconi2 • Giuseppe Pizzi3 • Giulia Lorenzoni1 Caterina Vivaldi4 • Alberta Cappelli2 • Giulio E. Vallati3 • Giuseppe Boni5 • Federico Cappelli3 • Andrea Paladini6 • Rosa Sciuto7 • Gianluca Masi4 • Rita Golfieri2 • Roberto Cioni1
•
Received: 20 March 2020 / Accepted: 20 June 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Background Y90 transarterial radioembolization (Y90RE) may improve clinical outcomes of unresectable intrahepatic cholangiocarcinoma (ICC); however, the optimal timing for Y90-RE is still debated. The purpose of this multicenter study was to retrospectively evaluate clinical outcomes of RE in patients with unresectable ICC, comparing three different settings: chemotherapy naı¨ve patients (group A), patients with disease control after first-line chemotherapy (group B) and patients with progression after first-line chemotherapy (group C). Materials and Methods The study included 81 consecutive patients (49 male, mean age 62.4 ± 11.8 years): 35 & Irene Bargellini [email protected] 1
Department of Interventional Radiology, Pisa University Hospital, Via Paradisa 2, 56126 Pisa, Italy
2
Radiology Unit, Department of Diagnostic and Preventive Medicine, S. Orsola-Malpighi University Hospital, Via Albertoni 15, 40138 Bologna, Italy
3
Department of Diagnostic and Interventional Radiology, IRCCS Regina Elena National Cancer Institute, via Elio Chianesi 53, 00144 Rome, Italy
4
Department of Medical Oncology, Pisa University Hospital, Via Roma 55, 56126 Pisa, Italy
5
Department of Nuclear Medicine, Pisa University Hospital, Via Roma 55, 56126 Pisa, Italy
6
Radiology Department, ‘‘Maggiore della Carita`’’ Hospital, University of Eastern Piedmont, Corso Giuseppe Mazzini 18, 28100 Novara, Italy
7
Department of Nuclear Medicine, IRCCS Regina Elena National Cancer Institute, via Elio Chianesi 53, 00144 Rome, Italy
(43.2%) patients were in group A, 19 (23.5%) in group B, and 27 (33.3%) in group C. Preprocedural clinical variables, tumour response according to RECIST 1.1 and overall survival (OS) were analysed and compared. Results Baseline demographic and clinical features did not differ significantly among groups, with the exception of prior surgical procedures that were significantly higher in group C patients, and macrovascular invasion that was more frequent in group B. Radiological response was available in 79 patients; objective response and disease control rates were 41.8% and 83.6%, respectively, without significant differences among groups. Median OS was 14.5 months (95% CI: 11.1–16.9) and was not significantly different among treatment groups. At multivariate analysis, tumour burden [ 50%, neutrophil-to-lymphocyte (N/L) ratio C 3 and radiological progression as best resp
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