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Factors affecting the response to Y-90 microsphere therapy in the cholangiocarcinoma patients

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Abstract

Objective

The aim of this study was to assess the early therapy response in patients with unresectable CCA who received Y-90 microsphere therapy for CCA and define the factors related to therapy response.

Materials and methods

Data of 19 patients [extrahepatic (n: 6) and intrahepatic (n: 13)] who received 24 sessions of Y-90 microsphere therapy [glass (n: 13) and resin (n: 11)] were retrospectively evaluated. Tumor load, tumor size, therapy response evaluation by RECIST1.1 criteria (n: 13), tumor lesion glycolysis (TLG), metabolic tumor volume (MTV), and metabolic therapy responses were evaluated (n: 8) using PERCIST1.0 criteria.

Results

No significant relation was found between therapy response and tumor localization, treated liver lobe, type of Y90 microspheres, the presence of previous therapies, perfusion pattern on hepatic artery perfusion scintigraphy, or patient demographics. The mean overall survival (OS) was 11.9 ± 2.3 months and was similar after both resin and glass Y90 microspheres; however, it was longer RECIST responders (p: 0.005). MTV and TLG values significantly decreased after therapy, and ΔMTV (− 45.4% ± 12.1) was found to be positively correlated with OS. No statistical difference was found between iCCA and eCCA, in terms of OS and response to therapy. Although not quantitatively displayed, better-perfused areas on HAPS images had a better metabolic response and less perfused areas were prone to local recurrences.

Conclusions

Both resin and glass microsphere therapy can be applied safely to iCCA and eCCA patients. Early therapy response can be evaluated with both RECIST and PERCIST criteria. Both anatomical and metabolic therapy response evaluations give complementary information.

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Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Bakirkoy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey

    Mehmet Bozkurt

  2. Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Gonca Eldem & Bora Peynircioğlu

  3. Department of Medical Oncology, Osmaniye Public Hospital, Osmaniye, Turkey

    Utku Burak Bozbulut

  4. Department of Nuclear Medicine, Faculty of Medicine, Hacettepe University, 06100, Sıhhiye, Ankara, Turkey

    Murat Fani Bozkurt, Eser Lay Ergün & Bilge Volkan-Salanci

  5. Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Saadettin Kılıçkap

  6. Department of Radiology, Koç University, Istanbul, Turkey

    Barbaros Çil

Authors
  1. Mehmet Bozkurt
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  2. Gonca Eldem
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  4. Murat Fani Bozkurt
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  9. Bilge Volkan-Salanci
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Correspondence to Bilge Volkan-Salanci.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the local ethics committee (No: GO 16/758-16) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Bozkurt, M., Eldem, G., Bozbulut, U.B. et al. Factors affecting the response to Y-90 microsphere therapy in the cholangiocarcinoma patients. Radiol med 126, 323–333 (2021). https://doi.org/10.1007/s11547-020-01240-9

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  • DOI: https://doi.org/10.1007/s11547-020-01240-9

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