Background: Intrahepatic cholangiocarcinoma (iCCA) is a rare, aggressive disease, which is rising in incidence in western countries.Curative resection is carried out in a minority of cases.For many patients with technically resectable disease, surgery is not pursued due to patient factors.ESMO guidelines suggest locoregional therapies including ablation and stereotactic body radiotherapy in unresectable liver confined iCCA and SIRT is increasingly being explored. Methods:We reviewed all patients with iCCA treated with SIRT with yytrium Y90 in St. Vincent's University Hospital from January 2016-September 2025.These cases were reviewed at the national liver cancer centre MDT and outcomes documented.A retrospective chart review was performed.Clinical data, imaging and treatment details, and survival data was collected and analysed.Results: A total of 13 SIRT procedures were performed in 9 patients from January 2016-September 2025.The median age at diagnosis was 75 years (range 42-90), and 5 were female. 1 patient had underlying cirrhosis.All had single lesions ranging 41-124mm with a median 65mm.The tumour was unresectable due to patient factors in 7 patients.SIRT was the first-line treatment in 7 cases, and the only treatment received in 6 cases.SIRT was second-line treatment for 2 patients.2 patients had second-line SIRT of a single lesion which responded to first-line chemotherapy but remained unresectable.At last follow up (06/11/2025) 5 patients were alive.Tumour responses included a complete response in 1 patient, partial response in 4 patients and stable disease in 3 patients.6 patients had progressed and median time to progression was 10 months (95% CI6-NR).Of these, 2 patients had further SIRT and 2 patients received palliative systemic therapy.3 patients had no evidence of disease progression after median follow-up of 8 months.Median overall survival from time of SIRT was 49 months (95% CI 10-NE).There were no documented adverse events. Conclusions:Performing SIRT in unresectable liver confined iCCA is feasible and provides local control, supporting SIRT as a safe and effective treatment option in this cohort.The additional benefit of SIRT in iCCA should be explored in prospective clinical trials.
Lynch et al. (Sun,) studied this question.