Yttrium-90 resin microspheres treatment may lead to longer overall survival in patients with cholangiocarcinoma based on patients’ objective response to treatment at 6 months, according to a new study published in the Journal of Vascular and Interventional Radiology. The incidence of liver toxicity was also less than 10% with the treatment. 

In order to evaluate the toxicity of Yttrium-90 resin microspheres treatment as well as its effect on the survival of patients with unresectable intrahepatic cholangiocarcinoma, a team of researchers led by Daniel Brown, MD from Vanderbilt University Medical Center in Nashville, TN conducted a multicenter, prospective, observational study.

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The team analyzed a total of 95 patients who were treated with Yttrium-90 resin microspheres between July 2015 and August 2020 at 27 different centers. The majority of patients (60%) had multifocal tumors and 27% had extrahepatic tumors. 

The median overall survival of the patients was 14 months. Chemotherapy naïve patients on the other hand, had a median overall survival of 10.6 months while those who received systemic therapy with cisplatin and gemcitabine was 11.4 months.

The overall survival of patients who showed a 6-month objective response to Yttrium-90 was 16.5 months. 

Patients without cirrhosis had better median overall survival at 19.1 months compared to those who did (12.2 months). 

Grade 3 or 4 bilirubin toxicities occurred in 7% of patients, while grade 3 albumin toxicity was seen in only 1.4% of patients.

The researchers concluded that Yttrium-90 resin microspheres treatment is a “useful therapy” for cholangiocarcinoma patients who cannot be treated with surgery. 

Cholangiocarcinoma is a group of rare malignant tumors originating from the biliary tree cells. Treatment typically consists of surgical intervention but in almost half of cases, the disease is considered unresectable due to late diagnosis.


Robinson TJ, Du L, Matsuoka L, et al. Survival and toxicities after Yttrium-90 transarterial radioembolization of cholangiocarcinoma in the RESiN registry. J Vasc Interv Radiol. Published online December 9, 2022. doi:10.1016/j.jvir.2022.10.042