Dose-Response and survival analysis after transarterial radioembolization for intrahepatic cholangiocarcinoma: A multicenter multicompartment dosimetry study.
Resin microsphere radioembolization showed a positive dose-response trend by positron emission tomography dosimetry in cholangiocarcinoma
Dose-Response and survival analysis after transarterial radioembolization for intrahepatic cholangiocarcinoma: A multicenter multicompartment dosimetry study.
We aimed to report real-world outcomes of transarterial radioembolization (transarterial radioembolization) in patients with intrahepatic cholangiocarcinoma (intrahepatic cholangiocarcinoma), focusing on different microsphere types and posttreatment dosimetric approaches in relation to dose-response and survival analyses.
This multicenter retrospective single-arm cohort study included adult patients with intrahepatic cholangiocarcinoma treated with Y-90 glass or resin microspheres using lobar or segmental approaches between January 2014 and December 2024 across 13 centers.
Seventeen patients were excluded from dose-response evaluation due to suboptimal posttreatment Y-90 imaging for dosimetric calculations.
Median (min-max) of administered activities were 2.7 (1.4-6.1) GBq for glass microspheres and 1.4 (0.6-1.8) GBq for resin microspheres (p = 0.004).
In separate analyses of SPECT and positron emission tomography studies, higher tumor absorbed dose and perfused liver absorbed dose values were observed in sessions analyzed with positron emission tomography-based dosimetry (for mean tumor absorbed dose; 249.2 ± 26.6 Gy vs 114.8 ± 15.7 Gy, p < 0.001, for mean perfused liver absorbed dose; 102.1 ± 10.4 Gy vs 59.4 ± 11.3 Gy, p = 0.031).
This multicenter analysis suggests that transarterial radioembolization may provide encouraging survival outcomes with acceptable toxicity in patients with intrahepatic cholangiocarcinoma, including salvage settings.
A potential dose-response association was identified in the resin microsphere subgroup evaluated with Y-90 positron emission tomography-based dosimetry.
Given the retrospective multicenter design and heterogeneity of imaging modalities, these findings should be considered hypothesis-generating and require confirmation in prospective studies using standardized posttreatment dosimetry.