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178
Radiation Segmentectomy and Modified Radiation Lobectomy for Unresectable Early-Stage Intrahepatic Cholangiocarcinoma
Aakash N Gupta1, Muhamad Serhal2, Andrew C Gordon2
1Section of Vascular and Interventional Radiology, Department of Radiology, Stanford University, Stanford, California.
Journal of Vascular and Interventional Radiology : JVIR
|December 21, 2024
Summary
Radiation segmentectomy (RS) and modified radiation lobectomy (mRL) show promise for unresectable intrahepatic cholangiocarcinoma (iCCA). These treatments are safe and effective, offering long-term survival comparable to surgery for early-stage iCCA.
Area of Science:
- Hepatobiliary Surgery
- Radiation Oncology
- Gastroenterology
Background:
- Intrahepatic cholangiocarcinoma (iCCA) is a challenging liver cancer.
- Surgical resection is the primary curative treatment but not always feasible.
- Advanced locoregional therapies are needed for unresectable cases.
Purpose of the Study:
- To validate the safety and effectiveness of radiation segmentectomy (RS) and modified radiation lobectomy (mRL).
- To evaluate long-term outcomes for unresectable, early-stage iCCA.
- To assess RS and mRL as therapeutic options for surgically unresectable iCCA.
Main Methods:
- Retrospective study of 15 patients with unresectable, solitary Stage I iCCA.
- Treatment with RS and mRL.
- Outcomes assessed: toxicity, tumor response (RECIST), time to progression, and overall survival (OS).
Main Results:
- No periprocedural mortality or hepatic deterioration.
- Grade 3+ clinical toxicity in 7% of patients.
- Best objective response rate of 60% by RECIST.
- Median OS of 72 months; 5-year OS rate of 50.3%.
Conclusions:
- RS and mRL are safe and effective for unresectable, early-stage iCCA.
- Outcomes are comparable to surgical resection.
- RS and mRL are viable therapeutic options for select iCCA patients.
