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

  • Héloïse Bourien
  • Xavier Palard
  • Yan Rolland
  • Fanny Le Du
  • Luc Beuzit
  • Thomas Uguen
  • Samuel Le Sourd
  • Marc Pracht
  • Vincent Manceau
  • Astrid Lièvre
  • Karim Boudjema
  • Etienne Garin
  • Julien EdelineEmail author
Original Article
  • 177 Downloads

Abstract

Purpose

Radioembolization (RE) is a promising treatment option for biliary tract cancers (BTC). We report here the largest series to date using this treatment modality.

Methods

We 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.

Results

The Progression-Free Survival and Overall Survival (OS) were 7.6 months [95% Confidence Interval (CI): 4.6–10.6] and 16.4 months [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 51.9 months. 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 11.4 months, log-rank p = 0.019).

Conclusion

Our 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.

Keywords

Radioembolization Dosimetry Biliary tract cancer 90Y Intrahepatic cholangiocarcinoma 

Notes

Funding

This work was supported in part by a grant from the French National Agency for Research called “Investissements d’Avenir” n°ANR-11-LABX-0018-01.

Compliance with ethical standards

Conflict of interests

Etienne Garin, Yan Rolland and Julien Edeline are consultants for BTG, manufacturer of glass microspheres.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Héloïse Bourien
    • 1
  • Xavier Palard
    • 2
  • Yan Rolland
    • 3
  • Fanny Le Du
    • 1
  • Luc Beuzit
    • 4
  • Thomas Uguen
    • 5
  • Samuel Le Sourd
    • 1
  • Marc Pracht
    • 1
  • Vincent Manceau
    • 2
  • Astrid Lièvre
    • 6
  • Karim Boudjema
    • 7
  • Etienne Garin
    • 2
    • 8
  • Julien Edeline
    • 1
    • 8
    Email author
  1. 1.Medical OncologyCentre Eugène MarquisRennesFrance
  2. 2.Nuclear MedicineCentre Eugène MarquisRennesFrance
  3. 3.Interventional RadiologyCentre Eugène MarquisRennesFrance
  4. 4.RadiologyCHU PontchaillouRennesFrance
  5. 5.HepatologyCHU PontchaillouRennesFrance
  6. 6.GastroenterologyCHU PontchaillouRennesFrance
  7. 7.Hepatobiliary SurgeryCHU PontchaillouRennesFrance
  8. 8.Univ Rennes, INSERM, INRA, Centre de Lutte contre le Cancer Eugène Marquis, Institut NUMECAN (Nutrition Metabolisms and Cancer)RennesFrance

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