Yttrium-90 glass microspheres radioembolization (RE) for biliary tract cancer a large single-center experience

Héloïse Bourien (1) , Xavier Palard (1) , Yan Rolland (1) , Fanny Le Du (1) , Luc Beuzit (2, 3) , Thomas Uguen (3) , Samuel Le Sourd (1) , Marc Pracht (1) , Vincent Manceau (1) , Astrid Lièvre (3) , Karim Boudjema (3) , Etienne Garin (4, 1) , Julien Edeline (4, 1)

1 CRLCC - CRLCC Eugène Marquis
2 Département de Radiologie [CHU de Rennes]
3 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
4 NuMeCan - Nutrition, Métabolismes et Cancer

Purpose - Radioembolization (RE) is a promising treatment option for biliary tract cancers (BTC). We report here the largest series to date using this treatment modality. Methods - We retrospectively studied data from 64 patients treated outside prospective clinical trial at our institution. We studied baseline characteristics as potential prognostic factors. We studied dose delivered to the tumor as predictive factors of outcomes in patients not receiving concomitant chemotherapy. Results - The Progression-Free Survival and Overall Survival (OS) were 7.6 months [95% Confidence Interval (CI): 4.6-10.6] and 16.4 months [95% CI: 7.8-25.0] in the whole cohort. The factors independently associated with OS in multivariable analysis were the primary localization of ICC (HR = 0.27, 95% CI: 0.11-0.68, p = 0.005) and a PS > 0 (HR = 2.21, 95% CI: 1.11-4.38, p = 0.024). During follow-up, 12 patients (19%) underwent surgery following downstaging, with a median OS of 51.9 months. In patients not treated with concomitant chemotherapy (n = 31), OS was significantly higher in patients with a dose delivered to the tumor 260Gy or higher than in patients with a dose delivered to the tumor lower than 260Gy (median 28.2 vs 11.4 months, log-rank p = 0.019). Conclusion - Our results confirm that RE is a promising treatment modality in BTC. A high proportion of patients could be downstaged to surgery, with promising long-term survival. Dose delivered to the tumor correlated with clinical outcomes when chemotherapy was not used concomitantly.

Mots clés: 90Y; Dosimetry; Intrahepatic cholangiocarcinoma; Biliary tract cancer; Radioembolization

Domaines: Sciences du Vivant [q-bio]; Cancer; Hépatologie et Gastroentérologie

Héloïse Bourien, Xavier Palard, Yan Rolland, Fanny Le Du, Luc Beuzit, et al.. Yttrium-90 glass microspheres radioembolization (RE) for biliary tract cancer a large single-center experience. European Journal of Nuclear Medicine and Molecular Imaging, 2019, 46 (3), pp.669-676. ⟨10.1007/s00259-018-4199-5⟩. ⟨hal-01937263⟩