SNFGE SNFGE
 
Thématique :
- Cancers autres (hors CCR et CHC)
Originalité :
Réexamen
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Dans certains cas
 
 
Nom du veilleur :
Professeur Sylvain MANFREDI
Coup de coeur :
 
 
British journal of Cancer
  2016/07  
 
  Jul 23;115(3):297-302  
  doi:10.1038/bjc.2016.191  
 
  Yttrium-90 radioembolization for unresectable/recurrent intrahepatic cholangiocarcinoma: a survival, efficacy and safety study  
 
  Mosconi C, Gramenzi A, Ascanio S, Cappelli A, Renzulli M, Pettinato C, Brandi G, Monari F, Cucchetti A, Trevisani F and Golfieri R  
  http://www.nature.com/bjc/journal/v115/n3/abs/bjc2016191a.html  
 
 

Background:
Intrahepatic cholangiocarcinoma (ICC) is a rapidly progressing malignancy; only a minority of the tumours can be resected and the palliative regimens have shown limited success. The aim of this study was to assess overall survival (OS), tumour response and the safety of radioembolization with yttrium-90 (90Y-TARE) in patients with unresectable/recurrent ICC.

Methods:
Survival was calculated from the date of the 90Y-TARE procedure. Target and overall Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST) and European Association for the Study of the Liver (EASL)—measuring delayed-phase contrast enhancement—treatment responses were assessed at 3 months.

Results:
The overall median survival was 17.9 months (95% CI: 14.3–21.4 months). Significantly longer survival was obtained in naive patients as compared with patients in whom TARE was preceded by other treatments, including surgery (52 vs 16 months, P=0.009). Significantly prolonged OS was recorded for patients with a response based on mRECIST and the EASL criteria while RECIST responses were not found to be associated with survival. Treatment was well-tolerated, and no mortality was reported within 30 days.

Conclusions:
In unresectable ICC, 90Y-TARE is safe and offers a survival benefit in naive patients, as well as in responders.

 
Question posée
 
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Commentaires

Etude montrant un gain en survie globale des patients avec cholangiocarcinome intrahépatique traités par radio-embolisation. Etude préliminaire sur un petit nombre de patients (23).

 
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