Transarterial Yttrium-90 Radioembolization for Unresectable Intrahepatic Cholangiocarcinoma: A Systematic Review and...

Area of Science:

• Interventional Radiology
• Hepatobiliary Oncology
• Nuclear Medicine

Background:

• Intrahepatic cholangiocarcinoma (ICC) is a challenging liver cancer with limited treatment options for unresectable cases.
• Yttrium-90 (90Y) radioembolization is an emerging therapy delivering targeted radiation to liver tumors.

Purpose of the Study:

• To evaluate the overall efficacy and survival impact of 90Y radioembolization in patients with unresectable ICC.
• To determine key response metrics including disease control, resectability downstaging, and tumor marker response.

Main Methods:

• A systematic literature review and meta-analysis were conducted.
• Included studies focused on 90Y radioembolization for unresectable ICC, analyzing data from 921 patients across 21 studies.
• Evaluated outcomes included disease control rate (DCR), downstaging to resectable status, CA19-9 response, progression-free survival (PFS), and overall survival (OS).

Main Results:

• The overall DCR was 82.3%, with 11% of patients downstaged to resectable status.
• The CA19-9 response rate was 67.2%.
• Median PFS was 7.8 months and median OS was 12.7 months, with survival proportions of 47% at 12 months and 31% at 18 months.

Conclusions:

• 90Y radioembolization demonstrates significant efficacy in managing unresectable ICC.
• The treatment facilitates tumor downstaging, achieves robust disease control, and improves patient survival.
• This meta-analysis supports 90Y radioembolization as a valuable therapeutic option for unresectable ICC.