title: Yttrium-90 radioembolization for unresectable standard-chemorefractory intrahepatic cholangiocarcinoma: survival, efficacy, and safety study.
abstract: OBJECTIVE
  To assess the overall survival, efficacy, and safety of radioembolization with yttrium-90 (Y90) for unresectable standard-chemorefractory intrahepatic cholangiocarcinoma (ICC).
  
  
  METHODS
  Patients with unresectable standard-chemorefractory ICC treated with Y90 were studied. Survival was calculated from the date of first Y90 procedure. Tumor response was assessed with the Response Evaluation Criteria in Solid Tumors criteria on follow-up computed tomography or magnetic resonance imaging scans. National Cancer Institute Common Terminology Criteria (NCI CTCAE), version 3, were used for complications. Statistical analysis was performed by the Kaplan-Meier estimator by the log rank test.
  
  
  RESULTS
  Nineteen patients underwent a total of 24 resin-based Y90 treatments. Median survival from the time of diagnosis and first Y90 procedure was 752 ± 193 [95 % confidence interval (CI) 374-1130] and 345 ± 128 (95 % CI 95-595) days, respectively. Median survival with Eastern Cooperative Oncology Group (ECOG) performance status 1 (n = 15) and ECOG performance status 2 (n = 4) was 450 ± 190 (95 % CI 78-822) and 345 ± 227 (95 % CI 0-790) days, respectively (p = .214). Patients with extrahepatic metastasis (n = 11) had a median survival of 404 ± 309 (95 % CI 0-1010) days versus 345 ± 117 (95 % CI 115-575) days for patients without metastasis (n = 8) (p = .491). No mortality was reported within 30 days from first Y90 radioembolization. One patient developed grade 3 thrombocytopenia as assessed by NCI CTCAE. Fatigue and transient abdominal pain were observed in 4 (21 %) and 6 (32 %) patients, respectively.
  
  
  CONCLUSIONS
  Y90 radioembolization is effective for unresectable standard-chemorefractory ICC.
authors.affiliation: Division of Interventional Radiology and Image Guided Medicine, Department of Radiology, Emory University School of Medicine, 1364 Clifton Road NE, Suite E-118, Atlanta, GA 30322, USA.
authors.forename: Shoaib
authors.initials: S
authors.lastname: Rafi
authors.forename: Sarat M
authors.initials: SM
authors.lastname: Piduru
authors.forename: Bassel
authors.initials: B
authors.lastname: El-Rayes
authors.forename: John S
authors.initials: JS
authors.lastname: Kauh
authors.forename: David A
authors.initials: DA
authors.lastname: Kooby
authors.forename: Juan M
authors.initials: JM
authors.lastname: Sarmiento
authors.forename: Hyun S
authors.initials: HS
authors.lastname: Kim
mesh_terms: D001650:Bile Duct Neoplasms; D001653:Bile Ducts, Intrahepatic; D016009:Chi-Square Distribution; D018281:Cholangiocarcinoma / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D015021:Yttrium Radioisotopes