Radiation Segmentectomy for the Treatment of Primary Hepatic Malignancies of the Caudate Lobe: A Case Series View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2022-08-26

AUTHORS

Manasi Arora, Beau B. Toskich, Andrew R. Lewis, Carlos A. Padula, Seyed Ali Montazeri, Charles Ritchie, Gregory Frey, Ricardo Paz-Fumagalli, J. Mark McKinney, Zlatko Devcic

ABSTRACT

PurposeTumors involving the caudate lobe present a unique therapeutic challenge due to their complex anatomy and the safety and efficacy of locoregional therapy can be variable. The purpose of this study is to analyze the outcomes of radiation segmentectomy for primary caudate lobe tumors.Materials and MethodsEight patients [5 women and 3 men; median age = 69 y (range 50–79)] that underwent transarterial radioembolization (TARE) using yttrium-90 (Y90) glass microspheres for primary caudate lobe tumors (hepatocellular carcinoma = 6, intrahepatic cholangiocarcinoma = 2) from August 2017 to March 2021 were retrospectively analyzed. Descriptive statistics, treatment parameters, tumor response (using modified response evaluation criteria in solid tumors), adverse events [using common terminology criteria for adverse events (CTCAE)], and survival outcomes were evaluated.ResultsEight primary caudate lobe tumors with a median size of 2.2 cm [interquartile range (IQR), 1.7–3.3] and Child–Pugh class A liver function underwent TARE of the caudate lobe. The median radiation dose was 596 Gy (IQR 356–1585), median total activity was 0.84 GBq (IQR 0.56–1.31), median specific activity was 473 Bq/sphere (IQR 226–671), and the median number of Y90 microspheres used was 1.4 million (IQR 1.2–3.4). All complications were CTCAE grade 1, and no clinically significant hilar plate complications were observed. In targeted tumors, complete response was seen in all patients. At a median follow-up period of 16.6 months (IQR 6.6–21.6) 75% (6/8) of patients were alive with no in-field progression.ConclusionRadiation segmentectomy of primary caudate lobe tumors appears effective and is well tolerated in this limited case series within the described treatment parameters.Level of EvidenceLevel 4, Case Series. More... »

PAGES

1485-1493

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00270-022-03250-8

DOI

http://dx.doi.org/10.1007/s00270-022-03250-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1150527650

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/36028573


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37 PurposeTumors
38 Y90 microspheres
39 Yttrium-90 Glass Microspheres
40 activity
41 adverse events
42 anatomy
43 case series
44 caudate lobe
45 caudate lobe tumor
46 challenges
47 class
48 complete response
49 complex anatomy
50 complications
51 descriptive statistics
52 dose
53 efficacy
54 events
55 field progression
56 follow
57 function
58 glass microspheres
59 grade 1
60 hepatic malignancies
61 levels
62 limited case series
63 liver function
64 lobe
65 lobe tumors
66 locoregional therapy
67 malignancy
68 materials
69 median follow
70 median number
71 median radiation dose
72 median size
73 median total activity
74 microspheres
75 months
76 number
77 outcomes
78 parameters
79 patients
80 period
81 plate complications
82 primary hepatic malignancy
83 progression
84 purpose
85 radiation dose
86 radiation segmentectomy
87 radioembolization
88 response
89 safety
90 segmentectomy
91 series
92 size
93 specific activity
94 sphere
95 statistics
96 study
97 survival outcomes
98 therapeutic challenge
99 therapy
100 total activity
101 transarterial radioembolization
102 treatment
103 treatment parameters
104 tumor response
105 tumors
106 unique therapeutic challenges
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