Repeated Treatment with 90Y-Microspheres in Intrahepatic Cholangiocarcinoma Relapsed After the First Radioembolization

Luca Filippi, Giovan Giuseppe Di Costanzo, Raffaella Tortora, Giuseppe Pelle, Roberto Cianni, Orazio Schillaci, Oreste Bagni

Research output: Contribution to journalArticlepeer-review


Background: The aim of this study was to evaluate the safety and efficacy of repeated administration of 90Y-microspheres in intrahepatic cholangiocarcinoma (ICC) relapsed after the first radioembolization (RE). Methods: Nine patients with ICC relapsed after the first 90Y-RE were enrolled. Six patients presented recurrence in the right hepatic lobe, 3 in the left lobe. All subjects underwent a second administration of 90Y-resin microspheres. Toxicity was assessed according to Common Terminology Criteria for Adverse Events (CTCAE, version 4.02). After the repeated treatment, all patients were submitted to follow-up with laboratory, imaging, and clinical examinations. Results: The mean cumulative activity administered considering both treatments was 2.7 ± 0.5 GBq. After the second treatment, 3 patients presented complete metabolic response (33.3%) and 6 had partial response (66.6%). The following adverse events were registered: transient increased levels of liver enzymes (grade 1 = 4; grade 2 = 2), hyperbilirubinemia (grade 1 = 2), ascites (grade 2 = 1), and duodenal ulcer (grade 2 = 1). Two patients developed a significant shrinking of the targeted hepatic lobe, as for radiation lobectomy. No case of RE-induced liver disease was registered. Median overall survival was 16.5 ± 1.4 months after the first RE. Conclusions: The authors' results suggest that repeated administration of 90Y-microspheres may be considered in patients affected by ICC relapsed after the first 90Y-RE.

Original languageEnglish
Pages (from-to)231-237
Number of pages7
JournalCancer Biotherapy and Radiopharmaceuticals
Issue number4
Publication statusPublished - May 2019


  • Aged
  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • Bile Duct Neoplasms/diagnostic imaging
  • Bile Ducts, Intrahepatic/diagnostic imaging
  • Cholangiocarcinoma/diagnostic imaging
  • Embolization, Therapeutic/adverse effects
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Liver/diagnostic imaging
  • Male
  • Microspheres
  • Middle Aged
  • Neoplasm Recurrence, Local/diagnostic imaging
  • Positron Emission Tomography Computed Tomography
  • Radiotherapy, Adjuvant/adverse effects
  • Retreatment/adverse effects
  • Retrospective Studies
  • Treatment Outcome
  • Yttrium Radioisotopes/administration & dosage


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