The use of yttrium 90-labeled glass microspheres in radiation segmentectomy/lobectomy appears to be safe and might extend overall survival in some unresectable cases of intrahepatic cholangiocarcinoma (iCCA), according to a new study published in the Journal of Clinical and Experimental Hepatology.
The study was based on the experiences of 16 patients with iCCA who were treated between May 2009 and October 2019, and the authors noted that the procedure had minimal side effects and no severe complications.
“Data from a recent multi-center database demonstrated 38 months median [overall survival] of [iCCA] patients after surgical resection,’ the authors wrote. “The current study shows that radiation segmentectomy/lobectomy is inferior to surgical resection in patients with [iCCA] based on these findings.”
“On the other hand, very promising results were observed in 4 patients who survived more than 20 months after radioembolization, and 2 of them survived over 3 and 4 years, respectively. One patient is still alive without evidence of disease.”
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A retrospective review of the patients’ medical records and imaging studies were conducted. The patients received radiation segmentectomy or lobectomy with ≥190 Gy delivered via yttrium 90-labeled glass microspheres, resulting in median overall survival times of 22.7 months from diagnosis but only 7 months from the time of the procedure.
Patients treated with chemotherapy alone had a median overall survival of only 11.7 months from diagnosis; however, those receiving radioembolization of iCCA had a median overall survival of 12.4 months. These results suggest that radiation segmentectomy and lobectomy might be a good option for select patients with unresectable iCCA.
The low number of patients in this study impedes the research team’s ability to identify specific prognostic factors that influence clinical outcomes. The authors recommend larger studies to help determine which patients would benefit most from this treatment approach.
Kumar P, Mhaskar R, Kim R, et al. Unresectable intrahepatic cholangiocarcinoma treated with radiation segmentectomy/lobectomy using yttrium 90-labeled glass microspheres. J Clin Exp Hepatol. Published online April 1, 2022. doi:10.1016/j.jceh.2022.03.008