CardioVascular and Interventional Radiology

, Volume 35, Issue 1, pp 105–116 | Cite as

Transarterial Hepatic Yttrium-90 Radioembolization in Patients with Unresectable Intrahepatic Cholangiocarcinoma: Factors Associated with Prolonged Survival

  • Ralf-T. Hoffmann
  • Philipp M. Paprottka
  • Agnes Schön
  • Fabian Bamberg
  • Alexander Haug
  • Eva-Maria Dürr
  • Barbara Rauch
  • Christoph T. Trumm
  • Tobias F. Jakobs
  • Thomas K. Helmberger
  • Maximilian F. Reiser
  • Frank T. Kolligs
Clinical Investigation



In unresectable intrahepatic cholangiocarcinoma (ICC), systemic chemotherapy often is viewed as the only option, although efficacy is limited. Radioembolization (RE) using yttrium-90 (90Y) microspheres is an accepted therapy for patients with hepatocellular-carcinoma or metastatic liver tumors. However, there are limited data on the value of RE in patients with ICC and few data on factors influencing prognosis. The purpose of our retrospective analysis was to establish which factors influenced time-to-progression (TTP) and overall survival (OS).


Patients with unresectable ICC were treated with 90Y resin-microspheres and assessed at 3-monthly intervals. Radiologic response was evaluated by using Response Criteria in Solid Tumors (RECIST). Baseline characteristics, biochemical/clinical toxicities, and response were examined for impact on TTP and OS.


Thirty-four treatments were administered to 33 patients without major complications. By RECIST, 12 patients had a partial response, 17 had stable disease, and 5 had progressive disease after 3 months. The median OS was 22 months posttreatment and 43.7 months postdiagnosis. Median TTP was 9.8 months. Survival and TTP were significantly prolonged in patients with ECOG 0 (vs. ECOG 1 or 2; median OS: 29.4, 10, and 5.1 months; TTP: 17.5, 6.9, and 2.4 months), tumor burden ≤25% (OS: 26.7 vs. 6 months; TTP: 17.5 vs. 2.3 months), or tumor response (PR or SD vs. PD; OS: 35.5, 17.7 vs. 5.7 months; TTP: 31.9, 9.8 vs. 2.5 months), respectively (P < 0.001).


Radioembolization is an effective and safe option for patients with unresectable ICC. Predictors for prolonged survival are performance status, tumor burden, and RECIST response.


Radioembolization Yttrium-90 microspheres SIR-Spheres SIRT Intrahepatic cholangiocarcinoma ICC 


Conflict of interest



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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2011

Authors and Affiliations

  • Ralf-T. Hoffmann
    • 1
    • 5
  • Philipp M. Paprottka
    • 1
    • 5
  • Agnes Schön
    • 3
  • Fabian Bamberg
    • 1
  • Alexander Haug
    • 2
  • Eva-Maria Dürr
    • 3
  • Barbara Rauch
    • 3
  • Christoph T. Trumm
    • 1
  • Tobias F. Jakobs
    • 1
  • Thomas K. Helmberger
    • 4
  • Maximilian F. Reiser
    • 1
  • Frank T. Kolligs
    • 3
  1. 1.Institute of Clinical RadiologyLudwig-Maximilians-UniversityMunichGermany
  2. 2.Department of Nuclear MedicineLudwig-Maximilians-UniversityMunichGermany
  3. 3.Department of Medicine IILudwig-Maximilians-UniversityMunichGermany
  4. 4.Department of Radiology, Interventional Radiology and Nuclear MedicineKlinikum BogenhausenMunichGermany
  5. 5.Institute of Clinical RadiologyUniversity of Munich – Campus GrosshadernMunichGermany

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