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Comparison of health-related quality of life after transarterial chemoembolization and transarterial radioembolization in patients with unresectable hepatocellular carcinoma

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Abstract

Purpose

The purpose of this study was to compare quality of life (QoL) after two different transarterial therapies [transarterial chemoembolization (TACE) and transarterial radioembolization (TARE)] for patients with unresectable hepatocellular carcinoma (HCC) to assess tumor therapy in palliative situation additional to traditional aims like survival or image response.

Material and methods

QoL was evaluated with two validated questionnaires (EORTC QLQ-30 and EORTC HCC18) before and 14d after treatment in 94 initial therapies (TACE n = 67; TARE n = 27). QoL changes after treatment were analyzed. Tumor response was evaluated using RECIST/WHO/mRECIST/EASL criteria. A multivariate linear regression was undertaken to identify potential influence factors on change of QoL.

Results

Mean return rate of questionnaires was 71.3% allowing analysis of 67 therapies (TACE n = 46; TARE n = 21). Initial global health status/QoL was significantly higher in TACE (62.5%) compared to TARE with 50.8%. Absolute global health decrease was higher in TACE (− 10.5%) compared to TARE (− 4.8%, p = 0.396). Also relative global health decrease was higher in TACE (− 16.82%) compared to TARE (− 9.37%). Findings for other items were corresponding, as less impairment was found for TARE compared to TACE for physical/social functioning, fatigue and pain. Objective mRECIST response rate was 22.8% in TACE and 21.1% in TARE.

Conclusion

Neither TACE nor TARE showed a major decrease in QoL after first treatment. TACE showed a slightly but not significantly higher decrease, so this study is not clearly in favor for one treatment. But with the addition that TARE showed less decrease even in patients with higher tumor burden and lower baseline.

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References

  1. Poyanli A, Rozanes I, Acunas B, Sencer S (2001) Palliative treatment of hepatocellular carcinoma by chemoembolization. Acta Radiol 42(6):602–607

    Article  CAS  PubMed  Google Scholar 

  2. Salem R, Gilbertsen M, Butt Z, et al. (2013) Increased quality of life among hepatocellular carcinoma patients treated with radioembolization, compared with chemoembolization. Clin Gastroenterol Hepatol 11(10):1358e.1–1365.e1

    Article  Google Scholar 

  3. Mancini R, Carpanese L, Sciuto R, et al. (2006) A multicentric phase II clinical trial on intra-arterial hepatic radiotherapy with 90yttrium SIR-spheres in unresectable, colorectal liver metastases refractory to i.v. chemotherapy: preliminary results on toxicity and response rates. In Vivo 20(6):711–714

    CAS  PubMed  Google Scholar 

  4. Chie W, Yu F, Li M, et al. (2015) Quality of life changes in patients undergoing treatment for hepatocellular carcinoma. Qual Life Res 24(10):2499–2506

    Article  PubMed  Google Scholar 

  5. Llovet J, Bruix J (2003) Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology 37(2):429–442

    Article  CAS  PubMed  Google Scholar 

  6. El-Serag HB (2011) Hepatocellular carcinoma. N Engl J Med 365:1118–1127

    Article  CAS  PubMed  Google Scholar 

  7. El-Serag HB (2012) Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology 142(6):1264e.1–1273.e1

    Article  Google Scholar 

  8. Wang Y, Chen M, Yan K, et al. (2007) Quality of life after radiofrequency ablation combined with transcatheter arterial chemoembolization for hepatocellular carcinoma: comparison with transcatheter arterial chemoembolization alone. Qual Life Res 16(3):389–397

    Article  PubMed  Google Scholar 

  9. European Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer (2012) EASL–EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 56(4):908–943

    Article  Google Scholar 

  10. Bruix J, Sherman M (2011) Management of hepatocellular carcinoma: an update. Hepatology 53(3):1020–1022

    Article  PubMed  PubMed Central  Google Scholar 

  11. Meropol NJ, Weinfurt KP, Burnett CB, et al. (2003) Perceptions of patients and physicians regarding phase I cancer clinical trials: implications for physician-patient communication. J Clin Oncol 13:2589–2596

    Article  Google Scholar 

  12. Moinpour CM (1994) Measuring quality of life: an emerging science. Semin Oncol 5(10):48–60

    Google Scholar 

  13. Brown MM, Brown CC (2013) Update on value-based medicine. Curr Opin Ophthalmol 24(3):183–189

    Article  PubMed  Google Scholar 

  14. Wang JH, Wang CC, Hung CH, Chen CL, Lu SN (2012) Survival comparison between surgical resection and radiofrequency ablation for patients in BCLC very early/early stage hepatocellular carcinoma. J Hepatol 56(2):412–418

    Article  PubMed  Google Scholar 

  15. Sangro B, Carpanese L, Cianni R, et al. (2011) Survival after yttrium-90 resin microsphere radioembolization of hepatocellular carcinoma across barcelona clinic liver cancer stages: a European evaluation. Hepatology. 54(3):868–878

    Article  PubMed  Google Scholar 

  16. Mao Y, Luo Z, Li B, Hu T (2012) Prospective study on the survival of HCC patients treated with transcatheter arterial lipiodol chemoembolization. Asian Pac J Cancer Prev 13(3):1039–1042

    Article  PubMed  Google Scholar 

  17. Xie ZR, Luo YL, Xiao FM, Liu Q, Ma Y (2015) Health-related quality of life of patients with intermediate hepatocellular carcinoma after liver resection or transcatheter arterial chemoembolization. Asian Pac J Cancer Prev 16(10):4451–4456

    Article  CAS  PubMed  Google Scholar 

  18. Wible B, Rilling W, Drescher P, et al. (2010) Longitudinal quality of life assessment of patients with hepatocellular carcinoma after primary transarterial chemoembolization. J Vasc Interv Radiol 21(7):1024–1030

    Article  PubMed  Google Scholar 

  19. Toro A, Pulvirenti E, Palermo F, Di Carlo I (2012) Health-related quality of life in patients with hepatocellular carcinoma after hepatic resection, transcatheter arterial chemoembolization, radiofrequency ablation or no treatment. Surg Oncol 21(1):e23–e30

    Article  PubMed  Google Scholar 

  20. Eltawil K, Berry R, Abdolell M, Molinari M (2012) Quality of life and survival analysis of patients undergoing transarterial chemoembolization for primary hepatic malignancies: a prospective cohort study. HPB (Oxford) 14(5):341–350

    Article  PubMed  PubMed Central  Google Scholar 

  21. Xing M, Webber G, Prajapati H, et al. (2015) Preservation of quality of life with doxorubicin drug-eluting bead transarterial chemoembolization for unresectable hepatocellular carcinoma: longitudinal prospective study. J Gastroenterol Hepatol 30(7):1167–1174

    Article  CAS  PubMed  Google Scholar 

  22. Blazeby J, Currie E, Zee BCY, et al. (2004) Development of a questionnaire module to supplement the EORTC QLQ-C30 to assess quality of life in patients with hepatocellular carcinoma, the EORTC QLQ-HCC18. Eur J Cancer 40(16):2439–2444

    Article  PubMed  Google Scholar 

  23. Aaronson NK, Ahmedzai S, Bergman B, et al. (1993) The european organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376

    Article  CAS  PubMed  Google Scholar 

  24. Li L, Mo FK, Chan SL, et al. (2017) Prognostic values of EORTC QLQ-C30 and QLQ-HCC18 index-scores in patients with hepatocellular carcinoma—clinical application of health-related quality-of-life data. BMC Cancer 17:8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Shim J, Lee H, Kim S, et al. (2012) Which response criteria best help predict survival of patients with hepatocellular carcinoma following chemoembolization? A validation study of old and new models. Radiology 262(2):708–718

    Article  PubMed  Google Scholar 

  26. Chie W, Blazeby J, Hsiao C, et al. (2012) International cross-cultural field validation of an european organization for research and treatment of cancer questionnaire module for patients with primary liver cancer, the european organization for research and treatment of cancer quality-of-life questionnaire HCC18. Hepatology 55(4):1122–1129

    Article  PubMed  Google Scholar 

  27. Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A, On behalf of the EORTC Quality of Life Group (2011) The EORTC QLQ-C30 Scoring Manual, 3rd edn. Brussels: European Organisation for Research and Treatment of Cancer.

  28. Bhangoo MS, Karnani DR, Hein PN, et al. (2015) Radioembolization with yttrium-90 microspheres for patients with unresectable hepatocellular carcinoma. J Gastrointest Oncol 6(5):469–478

    PubMed  PubMed Central  Google Scholar 

  29. Huang X, Liu X, Yu Y (2017) Depression and chronic liver diseases: are there shared underlying mechanisms? Front Mol Neurosci 10:134

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Osoba D, Rodrigues G, Myles J, Zee B, Pater J (1998) Interpreting the significance of changes in health-related quality-of-life scores. JCO 16(1):139–144

    Article  CAS  Google Scholar 

  31. Hinrichs JB, Hasdemir DB, Nordlohne M, et al. (2017) Health-related quality of life in patients with hepatocellular carcinoma treated with initial transarterial chemoembolization. Cardiovasc Intervent Radiol 40(10):1559–1566

  32. Hartrumpf KJ, Marquardt S, Werncke T, et al. (2018) Quality of life in patients undergoing repetitive TACE for the treatment of intermediate stage HCC. J Cancer Res Clin Oncol. https://doi.org/10.1007/s00432-018-2704-7

    Article  PubMed  Google Scholar 

  33. Lammer J, Malagari K, Vogl T, et al. (2010) Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study. Cardiovasc Intervent Radiol 33(1):41–52

    Article  PubMed  Google Scholar 

  34. Seyal AR, Gonzalez-Guindalini FD, Arslanoglu A, et al. (2015) Reproducibility of mRECIST in assessing response to transarterial radioembolization therapy in hepatocellular carcinoma. Hepatology 62(4):1111–1121

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    T. Kirchner, S. Marquardt, T. Werncke, F. Wacker & Thomas Rodt

  2. Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    M. M. Kirstein & A. Vogel

  3. Clinic for Nuclear Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    T. Brunkhorst

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  1. T. Kirchner
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Correspondence to Thomas Rodt.

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This study was not supported by any funding.

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The authors declared that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study. Consent for publication was obtained for every individual person’s data included in the study.

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Kirchner, T., Marquardt, S., Werncke, T. et al. Comparison of health-related quality of life after transarterial chemoembolization and transarterial radioembolization in patients with unresectable hepatocellular carcinoma. Abdom Radiol 44, 1554–1561 (2019). https://doi.org/10.1007/s00261-018-1802-y

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