Increased quality of life among hepatocellular carcinoma patients treated with radioembolization, compared with chemoembolization

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, Mary F. Mulcahy, Laura Kulik, Robert Lewandowski

*Corresponding author for this work

Research output: Contribution to journalArticle

104 Scopus citations

Abstract

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. ClinicalTrials.gov, number NCT00739167.

Original languageEnglish (US)
Pages (from-to)1358-1365.e1
JournalClinical Gastroenterology and Hepatology
Volume11
Issue number10
DOIs
StatePublished - Oct 2013

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Keywords

  • Comparison
  • Liver Cancer
  • Outcomes
  • Therapy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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