Publicaciones científicas
Factors Impacting Survival After Transarterial Radioembolization in Patients with Unresectable Intrahepatic Cholangiocarcinoma: A Combined Analysis of the Prospective CIRT Studies
Peter Reimer 1 , Valérie Vilgrain 2 3 , Dirk Arnold 4 , Tugsan Balli 5 , Rita Golfieri 6 , Romaric Loffroy 7 , Cristina Mosconi 6 , Maxime Ronot 2 3 , Christian Sengel 8 , Niklaus Schaefer 9 , Geert Maleux 10 , Graham Munneke 11 , Bora Peynircioglu 12 , Bruno Sangro 13 , Nathalie Kaufmann 14 , Maria Urdaniz 14 , Helena Pereira 15 16 , Niels de Jong 17 , Thomas Helmberger 18
Purpose: Transarterial radioembolization (TARE) with Yttrium-90 resin microspheres is a treatment option for patients with intrahepatic cholangiocarcinoma (ICC). However, optimising the timing of TARE in relation to systemic therapies and patient selection remains challenging. We report here on the effectiveness, safety, and prognostic factors associated with TARE for ICC in a combined analysis of the prospective observational CIRT studies (NCT02305459 and NCT03256994).
Methods: A combined analysis of 174 unresectable ICC patients enrolled between 2015 and 2020 was performed. Patient characteristics and treatment-related data were collected at baseline; adverse events and time-to-event data (overall survival [OS], progression-free survival [PFS] and hepatic PFS) were collected at every follow-up visit. Log-rank tests and a multivariable Cox proportional hazard model were used to identify prognostic factors.
Results: Patients receiving a first-line strategy of TARE in addition to any systemic treatment had a median OS and PFS of 32.5 months and 11.3 months. Patients selected for first-line TARE alone showed a median OS and PFS of 16.2 months and 7.4 months, whereas TARE as 2nd or further treatment-line resulted in a median OS and PFS of 12 and 9.3 months (p = 0.0028), and 5.1 and 3.5 months (p = 0.0012), respectively. Partition model dosimetry was an independent predictor for better OS (HR 0.59 [95% CI 0.37-0.94], p = 0.0259). No extrahepatic disease, no ascites, and < 6.1 months from diagnosis to treatment were independent predictors for longer PFS.
Conclusion: This combined analysis indicates that in unresectable ICC, TARE in combination with any systemic treatment is a promising treatment option.
CITA DEL ARTÍCULO Cardiovasc Intervent Radiol. 2024 Feb 6.
doi: 10.1007/s00270-023-03657-x