Real-life experience in the treatment of intrahepatic cholangiocarcinoma by ⁹⁰Y radioembolization: A multicenter retrospective study

Abstract

Rationale: Limited treatment options in patients suffering from intrahepatic cholangiocarinoma (iCCA) demand the introduction of new, catheter-based treatment options. Especially ⁹⁰Y radioembolization could expand therapeutic abilities beyond surgery or chemotherapy. Therefore, the purpose of this study was to identify factors associated with an improved median overall survival (mOS) in iCCA patients receiving radioembolization in a retrospective study in five major tertiary care centers. Material & Methods: A total of 138 radioembolization s in 128 patients with iCCA (female: 47.7%; male: 52.3%; mean age: 61.1±13.4y) were analyzed. Clinical data, imaging characteristics and radioembolization reports as well as data from RECIST 1.1 analysis performed 3, 6 and 12 months after radioembolization was collected. mOS was compared between different subgroups using Kaplan-Meier curves and the log-rank test. Results: Radioembolization was performed as first-line treatment in in 25.4%, as second-line treatment in 38.4% and as salvage treatment in 36.2%. In patients receiving first-line, second-line and salvage radioembolization, disease control rate was 68.6%, 52.8% and 54.0% after 3 months, 31.4%, 15.1%, 12.0% after 6 months and 17.1%, 5.7% and 6.0% after one year, respectively. In patients receiving radioembolization as first-line, second-line and salvage treatment, mOS was 12.0 months (95%CI, 7.6 to 23.4), 11.8 months (95%CI, 9.1 to 16.6) and 8.4 months (95%CI, 6.3 to 12.7), respectively. No significant differences between the three groups were observed (P = 0.15). Hepatic tumor burden did not significantly influence mOS (P = 0.12). Conclusion: Especially in advanced iCCA, second-line and salvage radioembolization might be important treatment options. In addition to ongoing studies investigating the role of radioembolization as first-line treatment, the role of radioembolization in the later treatment stages of the disease demands further attention.