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Better QoL with radioembolization treatment than TACE among HCC patients

Patients treated for hepatocellular carcinoma with ⁹⁰Y radioembolization had better health-related quality of life than transarterial chemoembolization recipients, despite presenting with more advanced disease in a recent study.

In the prospective observational study, researchers determined the health-related quality of life (QoL) among patients with hepatocellular carcinoma (HCC) before and 2 and 4 weeks after undergoing ⁹⁰Y radioembolization (n=29) or transarterial chemoembolization (TACE, n=27), via the 45-item Functional Assessment of Cancer Therapy–Hepatobiliary (FACT–Hep) survey. Researchers also developed an embolotherapy-specific score (ESS) from parameters within FACT–Hep that related to undergoing embolization, symptoms of pain and diarrhea, appetite, work ability and therapy side effects.

Patients who underwent radioembolization had more advanced disease according to Barcelona Clinic Liver Cancer (P=.02) and United Network for Organ Sharing (P=.03) staging.The groups had similar overall quality-of-life scores, which investigators attributed to the small sample size (P=.055; effect size=0.54). Patients who underwent radioembolization trended toward better overall QoL (P=.055) and had better social (P=.019) and functional well-being (P=.031) vs. TACE recipients. ESS scores also were better in the radioembolization group (P=.018).

Patients who underwent radioembolization trended toward more satisfactory coping with their illness (P=.083) at baseline, while TACE patients reported a loss of hope in fighting their disease (P=.056). Following 2 weeks of therapy, radioembolization patients experienced improved closeness to friends (P=.035). TACE recipients reported more symptoms of diarrhea (P=.058) and feelings of sadness (P=.034). After 4 weeks, the radioembolization group indicated improved coping satisfaction (P=.019) and appetite (P=.045); TACE recipients indicated feelings of nervousness (P=.047) and bothersome side effects (P=.029).

“Despite treatment of more advanced disease, health-related QoL parameters significantly favored ⁹⁰Y radioembolization over TACE in several subscales,” the researchers wrote. “The effect was most pronounced in the ESS. These represent compelling data suggesting that ⁹⁰Y radioembolization is better able to maintain health-related QoL when compared with TACE, for which significant deteriorations in health-related QoL subscales were observed.”

Disclosure: Researchers Riad Salem, Robert Lewandowski, Laura Kulik, Mary F. Mulcahy and Al B. Benson III are scientific advisors to Nordion.