中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 10
Oct.  2023
Turn off MathJax
Article Contents

Efficacy and safety of 125I intraluminal irradiation combined with lenvatinib in treatment of progressive extrahepatic cholangiocarcinoma

DOI: 10.3969/j.issn.1001-5256.2023.10.019
Research funding:

Henan Province Medical Science and Technology Tackling Program (joint construction) Project (LHGJ20190155);

Henan Province Medical Science and Technology Tackling Program (provincial ministry co-construction) Project (SBGJ202002072);

Henan Province Natural Science Foundation Project (202300410461)

More Information
  • Corresponding author: REN Jianzhuang, rjzjrk@126.com (ORCID: 0000-0001-7003-8678)
  • Received Date: 2023-03-23
  • Published Date: 2023-10-30
  •   Objective  To investigate the efficacy and safety of 125I intraluminal irradiation combined with lenvatinib in the treatment of progressive extrahepatic cholangiocarcinoma.  Methods  A retrospective analysis was performed for 25 patients with progressive extrahepatic cholangiocarcinoma who attended Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, from January 2018 to November 2021, and according to the treatment modality, they were divided into combination group with 13 patients (125I intraluminal irradiation combined with lenvatinib) and control group (125I intraluminal irradiation alone). The two groups were compared in terms of technical success rates, changes in liver function, stent patency, survival time, and incidence rates of adverse events. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon rank-sum test was used for comparison of continuous data with skewed distribution between two groups; the Fisher’s exact test was used for comparison of categorical data between groups. The Kaplan-Meier method and the log-rank test were used to evaluate survival time and stent patency.  Results  All patients had successful implantation of biliary stents and 125I particles, with a technical success rate of 100%. After 1 month of treatment, both groups had significant improvements in the serum levels of total bilirubin, direct bilirubin, alanine aminotransferase, and aspartate aminotransferase (all P<0.05). There were significant differences between the control group and the combination group in the duration of stent patency (7.0 months vs 9.5 months, P=0.022) and median survival time (11.5 months vs 15.6 months, P=0.008). There were no intolerable adverse events in the combination group during treatment.  Conclusion  Compared with 125I intraluminal irradiation alone, 125I intraluminal irradiation combined with lenvatinib has better efficacy and is a safe and effective treatment regimen for progressive extrahepatic cholangiocarcinoma.

     

  • loading
  • [1]
    RIZVI S, KHAN SA, HALLEMEIER CL, et al. Cholangiocarcinoma-evolving concepts and therapeutic strategies[J]. Nat Rev Clin Oncol, 2018, 15( 2): 95- 111. DOI: 10.1038/nrclinonc.2017.157.
    [2]
    FORNER A, VIDILI G, RENGO M, et al. Clinical presentation, diagnosis and staging of cholangiocarcinoma[J]. Liver Int, 2019, 39( Suppl 1): 98- 107. DOI: 10.1111/liv.14086.
    [3]
    VALLE J, WASAN H, PALMER DH, et al. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer[J]. N Engl J Med, 2010, 362( 14): 1273- 1281. DOI: 10.1056/NEJMoa0908721.
    [4]
    JIANG X, YANG JJ, LI H. Clinical effect of brachytherapy with 125I seed implantation in treatment of malignant hepatopancreatobiliary tumors[J]. J Clin Hepatol, 2016, 32( 12): 2300- 2304. DOI: 10.3969/j.issn.1001-5256.2016.12.014.

    江旭, 杨继金, 李慧. 碘-125粒子植入近程放疗在肝胆胰恶性肿瘤中的应用[J]. 临床肝胆病杂志, 2016, 32( 12): 2300- 2304. DOI: 10.3969/j.issn.1001-5256.2016.12.014.
    [5]
    JIAO D, ZHOU X, LI Z, et al. A newly designed biliary brachytherapy drainage catheter for patients with malignant biliary obstruction: A pilot study[J]. J Cancer Res Ther, 2020, 16( 2): 286- 291. DOI: 10.4103/jcrt.JCRT_804_19.
    [6]
    PAN T, LI MA, MU LW, et al. Stent placement with iodine-125 seeds strand effectively extends the duration of stent patency and survival in patients with unresectable malignant obstructive jaundice[J]. Scand J Gastroenterol, 2020, 55( 1): 123- 128. DOI: 10.1080/00365521.2019.1707275.
    [7]
    UENO M, IKEDA M, SASAKI T, et al. Phase 2 study of lenvatinib monotherapy as second-line treatment in unresectable biliary tract cancer: primary analysis results[J]. BMC Cancer, 2020, 20( 1): 1105. DOI: 10.1186/s12885-020-07365-4.
    [8]
    WANG Y, YANG X, WANG D, et al. Lenvatinib beyond first-line therapy in patients with advanced biliary tract carcinoma[J]. Front Oncol, 2022, 12: 785535. DOI: 10.3389/fonc.2022.785535.
    [9]
    HAN XW, LI YD, MA B, et al. Percutaneous transhepatic cholangiographic forceps biopsy in pathologic diagnosis for obstructive jaundice[J]. Chin J Radiol, 2004, 38( 10): 1025- 1029. DOI: 10.3760/j.issn:1005-1201.2004.10.003.

    韩新巍, 李永东, 马波, 等. 阻塞性黄疸经皮肝穿胆管造影术下胆管钳夹活检病理学诊断[J]. 中华放射学杂志, 2004, 38( 10): 1025- 1029. DOI: 10.3760/j.issn:1005-1201.2004.10.003.
    [10]
    CHAI J, LU D, LYU WF, et al. Percutaneous transhepatic biliary 125I seeds stent implantation for malignant biliary obstruction:analysis of its efficacy and safety[J]. J Intervent Radiol, 2022, 31( 7): 702- 706. DOI: 10.3969/j.issn.1008-794X.2022.07.014.

    柴杰, 鲁东, 吕维富, 等. 经皮肝穿刺胆道~(125)I粒子支架植入治疗恶性胆道梗阻疗效及安全性分析[J]. 介入放射学杂志, 2022, 31( 7): 702- 706. DOI: 10.3969/j.issn.1008-794X.2022.07.014.
    [11]
    WANG XJ, LI WH, HUANG R. Difference of curative effect between single biliary stent and biliary stent combined with 125I seed in the treatment of malignant obstructive jaundice[J]. J Pract Radiol, 2019, 35( 9): 1488- 1492. DOI: 10.3969/j.issn.1002-1671.2019.09.027.

    王学俊, 李文会, 黄锐. 单纯胆道支架与胆道支架联合125I粒子治疗恶性梗阻性黄疸的疗效差异[J]. 实用放射学杂志, 2019, 35( 9): 1488- 1492. DOI: 10.3969/j.issn.1002-1671.2019.09.027.
    [12]
    HU XS, PANG Q, LIU HC, et al. Percutaneous biliary metallic stent implantation combined with catheter-loaded 125I seeds in the treatment of locally advanced extrahepatic cholangiocarcinoma: evaluation of curative effect and analysis of prognostic factors[J]. J Intervent Radiol, 2019, 28( 4): 369- 375. DOI: 10.3969/j.issn.1008-794X.2019.04.015.

    胡小四, 庞青, 刘会春, 等. 经皮胆道支架联合导管载入式~(125)I粒子治疗局部进展期肝外胆管癌的疗效评价与预后因素分析[J]. 介入放射学杂志, 2019, 28( 4): 369- 375. DOI: 10.3969/j.issn.1008-794X.2019.04.015.
    [13]
    LI SC, WANG ZY. Surgical approach for locally advanced hilar cholangiocarcinoma[J]. Chin J Dig Surg, 2021, 20( 8): 858- 863. DOI: 10.3760/cma.j.cn115610-20210531-00255.

    李相成, 王子奕. 局部进展期肝门部胆管癌的外科治疗策略[J]. 中华消化外科杂志, 2021, 20( 8): 858- 863. DOI: 10.3760/cma.j.cn115610-20210531-00255.
    [14]
    EL-KHOUEIRY AB, RANKIN CJ, BEN-JOSEF E, et al. SWOG 0514: a phase II study of sorafenib in patients with unresectable or metastatic gallbladder carcinoma and cholangiocarcinoma[J]. Invest New Drugs, 2012, 30( 4): 1646- 1651. DOI: 10.1007/s10637-011-9719-0.
    [15]
    SUN W, PATEL A, NORMOLLE D, et al. A phase 2 trial of regorafenib as a single agent in patients with chemotherapy-refractory, advanced, and metastatic biliary tract adenocarcinoma[J]. Cancer, 2019, 125( 6): 902- 909. DOI: 10.1002/cncr.31872.
    [16]
    XU YF, YANG XQ, LU XF, et al. Fibroblast growth factor receptor 4 promotes progression and correlates to poor prognosis in cholangiocarcinoma[J]. Biochem Biophys Res Commun, 2014, 446( 1): 54- 60. DOI: 10.1016/j.bbrc.2014.02.050.
    [17]
    BOONJARASPINYO S, BOONMARS T, WU Z, et al. Platelet-derived growth factor may be a potential diagnostic and prognostic marker for cholangiocarcinoma[J]. Tumour Biol, 2012, 33( 5): 1785- 1802. DOI: 10.1007/s13277-012-0438-8.
    [18]
    YOSHIKAWA D, OJIMA H, IWASAKI M, et al. Clinicopathological and prognostic significance of EGFR, VEGF, and HER2 expression in cholangiocarcinoma[J]. Br J Cancer, 2008, 98( 2): 418- 425. DOI: 10.1038/sj.bjc.6604129.
    [19]
    OKAMOTO K, KODAMA K, TAKASE K, et al. Antitumor activities of the targeted multi-tyrosine kinase inhibitor lenvatinib(E7080) against RET gene fusion-driven tumor models[J]. Cancer Lett, 2013, 340( 1): 97- 103. DOI: 10.1016/j.canlet.2013.07.007.
    [20]
    MATSUI J, YAMAMOTO Y, FUNAHASHI Y, et al. E7080, a novel inhibitor that targets multiple kinases, has potent antitumor activities against stem cell factor producing human small cell lung cancer H146, based on angiogenesis inhibition[J]. Int J Cancer, 2008, 122( 3): 664- 671. DOI: 10.1002/ijc.23131.
    [21]
    YAMAMOTO Y, MATSUI J, MATSUSHIMA T, et al. Lenvatinib, an angiogenesis inhibitor targeting VEGFR/FGFR, shows broad antitumor activity in human tumor xenograft models associated with microvessel density and pericyte coverage[J]. Vasc Cell, 2014, 6: 18. DOI: 10.1186/2045-824X-6-18.
    [22]
    TOHYAMA O, MATSUI J, KODAMA K, et al. Antitumor activity of lenvatinib(e7080): an angiogenesis inhibitor that targets multiple receptor tyrosine kinases in preclinical human thyroid cancer models[J]. J Thyroid Res, 2014, 2014: 638747. DOI: 10.1155/2014/638747.
    [23]
    TORRENS L, MONTIRONI C, PUIGVEHÍ M, et al. Immunomodulatory effects of lenvatinib plus anti-programmed cell death protein 1 in mice and rationale for patient enrichment in hepatocellular carcinoma[J]. Hepatology, 2021, 74( 5): 2652- 2669. DOI: 10.1002/hep.32023.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(3)  / Tables(4)

    Article Metrics

    Article views (198) PDF downloads(30) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return