Irene Bargellini1, Cristina Mosconi2, Giuseppe Pizzi3, Giulia Lorenzoni4, Caterina Vivaldi5, Alberta Cappelli2, Giulio E Vallati3, Giuseppe Boni6, Federico Cappelli3, Andrea Paladini7, Rosa Sciuto8, Gianluca Masi5, Rita Golfieri2, Roberto Cioni4. 1. Department of Interventional Radiology, Pisa University Hospital, Via Paradisa 2, 56126, Pisa, Italy. irenebargellini@hotmail.com. 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 Interventional Radiology, Pisa University Hospital, Via Paradisa 2, 56126, Pisa, Italy. 5. Department of Medical Oncology, Pisa University Hospital, Via Roma 55, 56126, Pisa, Italy. 6. Department of Nuclear Medicine, Pisa University Hospital, Via Roma 55, 56126, Pisa, Italy. 7. Radiology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Corso Giuseppe Mazzini 18, 28100, Novara, Italy. 8. Department of Nuclear Medicine, IRCCS Regina Elena National Cancer Institute, via Elio Chianesi 53, 00144, Rome, Italy.
Abstract
BACKGROUND: Y90 transarterial radioembolization (Y90-RE) 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 naïve 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 (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 ≥ 3 and radiological progression as best response resulted to be significant (P < 0.05) independent factors, negatively associated with OS. CONCLUSION: Y90-RE is a valuable treatment option in unresectable ICC, irrespectively from the timing of treatment. Tumour extension, N/L ratio and radiological response affect post-treatment survival.
BACKGROUND: Y90 transarterial radioembolization (Y90-RE) 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 naïve 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 (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 ≥ 3 and radiological progression as best response resulted to be significant (P < 0.05) independent factors, negatively associated with OS. CONCLUSION: Y90-RE is a valuable treatment option in unresectable ICC, irrespectively from the timing of treatment. Tumour extension, N/L ratio and radiological response affect post-treatment survival.
Authors: Matthias P Fabritius; Najib Ben Khaled; Wolfgang G Kunz; Jens Ricke; Max Seidensticker Journal: J Clin Med Date: 2021-11-26 Impact factor: 4.241