Yttrium-90 glass microspheres radioembolization (RE) for biliary tract cancer: a large single-center experience

被引:46
作者
Bourien, Heloise [1 ]
Palard, Xavier [2 ]
Rolland, Yan [3 ]
Le Du, Fanny [1 ]
Beuzit, Luc [4 ]
Uguen, Thomas [5 ]
Le Sourd, Samuel [1 ]
Pracht, Marc [1 ]
Manceau, Vincent [2 ]
Lievre, Astrid [6 ]
Boudjema, Karim [7 ]
Garin, Etienne [2 ,8 ]
Edeline, Julien [1 ,8 ]
机构
[1] Ctr Eugene Marquis, Med Oncol, Rennes, France
[2] Ctr Eugene Marquis, Nucl Med, Rennes, France
[3] Ctr Eugene Marquis, Intervent Radiol, Rennes, France
[4] CHU Pontchaillou, Radiol, Rennes, France
[5] CHU Pontchaillou, Hepatol, Rennes, France
[6] CHU Pontchaillou, Gastroenterol, Rennes, France
[7] CHU Pontchaillou, Hepatobiliary Surg, Rennes, France
[8] Univ Rennes, Ctr Lutte Canc Eugene Marquis, Inst NUMECAN Nutr Metab & Canc, INSERM,INRA, F-35000 Rennes, France
关键词
Radioembolization; Dosimetry; Biliary tract cancer; 90Y; Intrahepatic cholangiocarcinoma; UNRESECTABLE INTRAHEPATIC CHOLANGIOCARCINOMA; RESPONSE EVALUATION CRITERIA; INTERNAL RADIATION-THERAPY; HEPATOCELLULAR-CARCINOMA PATIENTS; SOLID TUMORS; GEMCITABINE; SURVIVAL; CISPLATIN; LIVER; CHEMOTHERAPY;
D O I
10.1007/s00259-018-4199-5
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PurposeRadioembolization (RE) is a promising treatment option for biliary tract cancers (BTC). We report here the largest series to date using this treatment modality.MethodsWe retrospectively studied data from 64 patients treated outside prospective clinical trial at our institution. We studied baseline characteristics as potential prognostic factors. We studied dose delivered to the tumor as predictive factors of outcomes in patients not receiving concomitant chemotherapy.ResultsThe Progression-Free Survival and Overall Survival (OS) were 7.6months [95% Confidence Interval (CI): 4.6-10.6] and 16.4months [95% CI: 7.8-25.0] in the whole cohort. The factors independently associated with OS in multivariable analysis were the primary localization of ICC (HR=0.27, 95% CI: 0.11-0.68, p=0.005) and a PS>0 (HR=2.21, 95% CI: 1.11-4.38, p=0.024). During follow-up, 12 patients (19%) underwent surgery following downstaging, with a median OS of 51.9months. In patients not treated with concomitant chemotherapy (n=31), OS was significantly higher in patients with a dose delivered to the tumor 260Gy or higher than in patients with a dose delivered to the tumor lower than 260Gy (median 28.2 vs 11.4months, log-rank p=0.019).ConclusionOur results confirm that RE is a promising treatment modality in BTC. A high proportion of patients could be downstaged to surgery, with promising long-term survival. Dose delivered to the tumor correlated with clinical outcomes when chemotherapy was not used concomitantly.
引用
收藏
页码:669 / 676
页数:8
相关论文
共 35 条
[31]   Radioembolization for Unresectable Intrahepatic Cholangiocarcinoma: Review of Safety, Response Evaluation Criteria in Solid Tumors 1.1 Imaging Response and Survival [J].
Swinburne, Nathaniel C. ;
Biederman, Derek M. ;
Besa, Cecilia ;
Tabori, Nora E. ;
Fischman, Aaron M. ;
Patel, Rahul S. ;
Nowakowski, Francis Scott ;
Gunasekaran, Ganesh ;
Schwartz, Myron E. ;
Lookstein, Robert A. ;
Kim, Edward .
CANCER BIOTHERAPY AND RADIOPHARMACEUTICALS, 2017, 32 (05) :161-168
[32]   Cisplatin and gemcitabine for advanced biliary tract cancer: a meta-analysis of two randomised trials [J].
Valle, J. W. ;
Furuse, J. ;
Jitlal, M. ;
Beare, S. ;
Mizuno, N. ;
Wasan, H. ;
Bridgewater, J. ;
Okusaka, T. .
ANNALS OF ONCOLOGY, 2014, 25 (02) :391-398
[33]   Cisplatin plus Gemcitabine versus Gemcitabine for Biliary Tract Cancer. [J].
Valle, Juan ;
Wasan, Harpreet ;
Palmer, Daniel H. ;
Cunningham, David ;
Anthoney, Alan ;
Maraveyas, Anthony ;
Madhusudan, Srinivasan ;
Iveson, Tim ;
Hughes, Sharon ;
Pereira, Stephen P. ;
Roughton, Michael ;
Bridgewater, John .
NEW ENGLAND JOURNAL OF MEDICINE, 2010, 362 (14) :1273-1281
[34]   Surgical Resection Does Not Improve Survival in Multifocal Intrahepatic Cholangiocarcinoma: A Comparison of Surgical Resection with Intra-Arterial Therapies [J].
Wright, G. Paul ;
Perkins, Samantha ;
Jones, Heather ;
Zureikat, Amer H. ;
Marsh, J. Wallis ;
Holtzman, Matthew P. ;
Zeh, Herbert J., III ;
Bartlett, David L. ;
Pingpank, James F., Jr. .
ANNALS OF SURGICAL ONCOLOGY, 2018, 25 (01) :83-90
[35]   Gemcitabine in the chemoradiotherapy for locally advanced pancreatic cancer: A meta-analysis [J].
Zhu, Chang-Peng ;
Shi, Jian ;
Chen, Yue-Xiang ;
Xie, Wei-Fen ;
Lin, Yong .
RADIOTHERAPY AND ONCOLOGY, 2011, 99 (02) :108-113