Yttrium-90 radioembolization for unresectable/recurrent intrahepatic cholangiocarcinoma: a survival, efficacy and safety study.

BACKGROUND: Intrahepatic cholangiocarcinoma (ICC) is a rapidly progressing malignancy; only a minority of the tumours can be resected and the palliative regimens have shown limited success. The aim of this study was to assess overall survival (OS), tumour response and the safety of radioembolization with yttrium-90 ((90)Y-TARE) in patients with unresectable/recurrent ICC.

METHODS: Survival was calculated from the date of the (90)Y-TARE procedure. Target and overall Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST) and European Association for the Study of the Liver (EASL)-measuring delayed-phase contrast enhancement-treatment responses were assessed at 3 months.

RESULTS: The overall median survival was 17.9 months (95% CI: 14.3-21.4 months). Significantly longer survival was obtained in naive patients as compared with patients in whom TARE was preceded by other treatments, including surgery (52 vs 16 months, P=0.009). Significantly prolonged OS was recorded for patients with a response based on mRECIST and the EASL criteria while RECIST responses were not found to be associated with survival. Treatment was well-tolerated, and no mortality was reported within 30 days.

CONCLUSIONS: In unresectable ICC, (90)Y-TARE is safe and offers a survival benefit in naive patients, as well as in responders.