Personalised radioembolization improves outcomes in refractory intra-hepatic cholangiocarcinoma: a multicenter study

Purpose Reported outcomes of patients with intra-hepatic cholangiocarcinoma (IH-CCA) treated with radioembolization are highly variable, which indicates differences in included patients’ characteristics and/or procedure-related variables. This study aimed to identify patient- and treatment-related v...

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Bibliographic Details
Published in:European journal of nuclear medicine and molecular imaging 2019-10, Vol.46 (11), p.2270-2279
Main Authors: Levillain, Hugo, Duran Derijckere, Ivan, Ameye, Lieveke, Guiot, Thomas, Braat, Arthur, Meyer, Carsten, Vanderlinden, Bruno, Reynaert, Nick, Hendlisz, Alain, Lam, Marnix, Deroose, Christophe M., Ahmadzadehfar, Hojjat, Flamen, Patrick
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Alanine
Alanine transaminase
Aspartate aminotransferase
Bilirubin
Cardiology
Cholangiocarcinoma
Cholangiocarcinoma - drug therapy
Cholangiocarcinoma - radiotherapy
Embolization, Therapeutic
Female
Fluorodeoxyglucose F18
Hazards
Humans
Identification methods
Imaging
Liver
Liver Neoplasms - diagnostic imaging
Lymph nodes
Lymphatic Metastasis
Lymphatic system
Male
Medicine
Medicine & Public Health
Metastases
Metastasis
Microspheres
Middle Aged
Multivariate analysis
Nuclear Medicine
Oncology
Oncology – Digestive tract
Original Article
Orthopedics
Partitions
Patients
Positron emission tomography
Positron Emission Tomography Computed Tomography
Precision Medicine
Predictions
Proportional Hazards Models
Radiation
Radiation dosage
Radiology
Rank tests
Retrospective Studies
Serum albumin
Single photon emission computed tomography
Statistical analysis
Statistical models
Technetium Tc 99m Aggregated Albumin
Treatment Outcome
Tumors
Variables
Yttrium Radioisotopes - therapeutic use
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Summary:Purpose Reported outcomes of patients with intra-hepatic cholangiocarcinoma (IH-CCA) treated with radioembolization are highly variable, which indicates differences in included patients’ characteristics and/or procedure-related variables. This study aimed to identify patient- and treatment-related variables predictive for radioembolization outcome. Methods This retrospective multicenter study enrolled 58 patients with unresectable and chemorefractory IH-CCA treated with resin 90 Y-microspheres. Clinicopathologic data were collected from patient records. Metabolic parameters of liver tumor(s) and presence of lymph node metastasis were measured on baseline 18 F-FDG-PET/CT. 99m Tc-MAA tumor to liver uptake ratio (TLR MAA ) was computed for each lesion on the SPECT-CT. Activity prescription using body-surface-area (BSA) or more personalized partition-model was recorded. The study endpoint was overall survival (OS) starting from date of radioembolization. Statistical analysis was performed by the log-rank test and multivariate Cox’s proportional hazards model. Results Median OS (mOS) post-radioembolization of the entire cohort was 10.3 months. Variables associated with significant differences in terms of OS were serum albumin (hazard ratio (HR) = 2.78, 95%CI:1.29–5.98, p  = 0.002), total bilirubin (HR = 2.17, 95%CI:1.14–4.12, p  = 0.009), aspartate aminotransferase (HR = 2.96, 95%CI:1.50–5.84, p  
ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-019-04427-z