Is there a role for Ytrrium-90 in the treatment of unresectable and metastatic intrahepatic cholangiocarcinoma?

Am J Surg. 2018 Mar;215(3):467-470. doi: 10.1016/j.amjsurg.2017.11.022. Epub 2018 Feb 2.

Abstract

Background: Selective internal radiation therapy (SIRT) with Ytrrium-90 (Y-90) has been used to treat hepatic malignancies with success. This study focuses on the efficacy and safety of Y-90 in the treatment of unresectable and metastatic intrahepatic cholangiocarcinoma (ICC).

Methods: A single-institution retrospective case review was performed for patients with unresectable and metastatic ICC treated with Y-90 between 2006 and 2016.

Results: Seventeen patients with ICC underwent 21 Y-90 treatments. Four patients had undergone prior liver resection, and six patients had extrahepatic disease at the time of treatment. Five year overall survival was 26.8%, with a median survival of 33.6 months. One patient underwent margin negative liver resection after a single treatment. Complications were appreciated in two cases. Ninety-day mortality was 0%.

Conclusion: Treatment of ICC using Y-90 is a safe and promising procedure. Further research is needed to clarify its role in the treatment of unresectable and metastatic ICC.

Keywords: Intrahepatic cholangiocarcinoma; Unresectable primary liver cancer; Yttrium-90 selective internal radiation therapy.

MeSH terms

  • Adult
  • Aged
  • Bile Duct Neoplasms / mortality
  • Bile Duct Neoplasms / pathology
  • Bile Duct Neoplasms / radiotherapy*
  • Bile Ducts, Intrahepatic* / pathology
  • Cholangiocarcinoma / mortality
  • Cholangiocarcinoma / pathology
  • Cholangiocarcinoma / radiotherapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Linear Models
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Radiopharmaceuticals / therapeutic use*
  • Retrospective Studies
  • Treatment Outcome
  • Yttrium Radioisotopes / therapeutic use*

Substances

  • Radiopharmaceuticals
  • Yttrium Radioisotopes
  • Yttrium-90