Survival and Toxicities after Yttrium-90 Transarterial Radioembolization of Cholangiocarcinoma in the RESiN Registry |
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| Institution: | 1. Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee;2. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee;3. Division of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee;4. Division of Interventional Radiology, Vanderbilt University Medical Center, Nashville, Tennessee;5. Division of Interventional Radiology, Stanford University, Palo Alto, California;6. Department of Radiation Oncology, Sarah Cannon Research Institute, Nashville, Tennessee;7. Division of Interventional Radiology, Miami Cardiac and Vascular Institute/Miami Cancer Institute, Miami, Florida;8. Division of Interventional Radiology, Atrium Wake Forest Baptist Health, Winston-Salem, North Carolina;9. Division of Interventional Radiology, University of Kansas, Kansas City, Kansas;10. Division of Interventional Radiology and Image-Guided Therapy, Emory University School of Medicine, Atlanta, Georgia;11. Division of Interventional Radiology, Christiana Medical Center, Newark, Delaware;12. Division of Interventional Radiology, Carolinas Medical Center, Charlotte, North Carolina;13. Division of Interventional Radiology, Radiology Associates of Florida, Tampa, Florida;1. Division of Vascular and Interventional Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin;2. Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin;3. Department of Pathobiology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania;4. Division of Vascular and Interventional Radiology, Department of Radiology, University of California San Diego, La Jolla, California;1. Department of Radiology, Kaiser Permanente Oakland Medical Center, Oakland, California;2. Department of Radiology, Kaiser Permanente Richmond Medical Center, Richmond, California;3. Department of Psychology, George Mason University, Fairfax, Virginia;1. Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York;2. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York;1. Vanderbilt University School of Medicine, Nashville, Tennessee;2. Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee;3. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee;4. Division of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee;5. Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee |
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| Abstract: | PurposeTo report outcomes in patients with intrahepatic cholangiocarcinoma treated with yttrium-90 resin microspheres (transarterial radioembolization TARE]) from a multicenter, prospective observational registry.Materials and MethodsNinety-five patients (median age, 67 years interquartile range {IQR}, 59–74]; 50 men) were treated in 27 centers between July 2015 and August 2020. Baseline demographic characteristics included imaging findings, performance status, and previous systemic or locoregional treatments. Dosimetry method was tracked. Overall survival (OS) and progression-free survival were calculated using the Kaplan-Meier method. The best imaging response was calculated using the Response Evaluation Criteria in Solid Tumors v1.1. Grade ≥3 toxicities were assessed using Common Terminology Criteria for Adverse Events v5. Cox regression analysis was performed.ResultsFifty-two of 86 (60%) patients had multifocal tumors, and 24/89 (27%) had extrahepatic tumors. The median index tumor diameter was 7.0 cm (IQR, 4.9–10 cm). The activity calculation method was reported in 59/95 (62%) patients, with body surface area being the most frequently used method (45/59, 76%). Median OS for the cohort was 14 months (95% confidence interval, 12–22). OS at 3, 6, 12, and 24 months was 94%, 80%, 63%, and 34%, respectively. Median OS was longer in patients without cirrhosis (19.1 vs 12.2 months, P = .05). Cirrhosis, previous chemotherapy (OS, 19.1 vs 10.6 months for treatment-naïve; P = .07), and imaging response at 6 months (OS, 16.4 vs 9.5 months for no response; P = .06) underwent regression analysis. Imaging response predicted OS at regression (hazard ratio, 0.39; P = .008). Grade 3–4 bilirubin toxicities were noted in 5 of 72 (7%) patients. Grade 3 albumin toxicity was noted in 1 of 72 (1.4%) patients.ConclusionsObjective response at 6 months predicted longer OS after TARE for intrahepatic cholangiocarcinoma. The incidence of liver function toxicity was <10%. |
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