Increased Quality of Life Among Hepatocellular Carcinoma Patients Treated With Radioembolization, Compared With Chemoembolization

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• 作者：Riad Salem ; Margaret Gilbertsen ; Zeeshan Butt ; Khairuddin Memon ; Michael Vouche ; Ryan Hickey ; Talia Baker ; Michael M. Abecassis ; Rohi Atassi ; Ahsun Riaz ; David Cella ; James L. Burns ; Daniel Ganger ; Al B. Benson III ; Mary F. Mulcahy ; Laura Kulik ; Robert Lew ; owski
• 关键词：Liver Cancer ; Therapy ; Outcomes ; Comparison
• 刊名：Clinical Gastroenterology and Hepatology
• 出版年：2013
• 出版时间：October, 2013
• 年：2013
• 卷：11
• 期：10
• 页码：1358-1365.e1
• 全文大小：339 K

文摘

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Background & Aims

Quality of life (QoL) is an important aspect of any palliative treatment. However, few data are available from studies comparing how embolotherapy affects QoL for patients with hepatocellular carcinoma (HCC). We performed a health-related QoL study in patients with HCC treated by transarterial chemoembolization (TACE) or ⁹⁰Y radioembolization.

Methods

We performed a prospective study of patients undergoing ⁹⁰Y radioembolization (n?= 29) or TACE (n?= 27) for HCC. We assessed patients before treatment and 2 and 4 weeks after treatment using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) survey. We compared differences in health-related QoL between the treatment groups using linear regression repeated-measures analysis.

Results

At baseline, the groups had comparable baseline Child-Pugh class and performance statuses, although patients undergoing TACE had lower tumor burdens (P?= .018) and less-advanced disease, based on United Network for Organ Sharing and Barcelona stage (P?= .03 and P?=?.02, respectively), permitting injections at segmental arteries (P < .0001). There were no significant differences between groups in overall FACT-Hep health-related QoL scores (P?=?.055, effect size [ES], .54), owing to a limited sample size. Despite the more advanced disease of patients who received ⁹⁰Y radioembolization, they had a significantly better QoL, based on social well being (P?= .019; ES, .65), functional well-being (P?= .031; ES, .60), and embolotherapy-specific scores (P?= .018; ES, .67). They also had a trend toward better overall QoL (P?= .055; ES, .54) and higher Trial Outcome Index (P?= .05; ES, .56) and FACT-Hep scores (P?= .071; ES, .52).

Conclusions

In a prospective study, although ⁹⁰Y radioembolization was used to treat patients with more advanced disease, those who received this treatment had significant increases in several features of QoL, whereas patients who received TACE had decreases in QoL scores. However, because of the limited sample size, there was no significant difference in overall FACT-Hep health-related QoL scores. The increase was greatest in the embolotherapy-specific score. number .