title: Increased quality of life among hepatocellular carcinoma patients treated with radioembolization, compared with chemoembolization.
abstract: OBJECTIVE
  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 (90)Y radioembolization.
  
  
  METHODS
  We performed a prospective study of patients undergoing (90)Y 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 (90)Y 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 (90)Y 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.
authors: Department of Radiology, Division of Interventional Oncology, Northwestern University, Chicago, Illinois; Department of Medicine, Division of Hematology/Oncology, Northwestern University, Chicago, Illinois. Electronic address: r-salem@northwestern.edu.
authors: Riad
authors: R
authors: Salem
authors: Margaret
authors: M
authors: Gilbertsen
authors: Zeeshan
authors: Z
authors: Butt
authors: Khairuddin
authors: K
authors: Memon
authors: Michael
authors: M
authors: Vouche
authors: Ryan
authors: R
authors: Hickey
authors: Talia
authors: T
authors: Baker
authors: Michael M
authors: MM
authors: Abecassis
authors: Rohi
authors: R
authors: Atassi
authors: Ahsun
authors: A
authors: Riaz
authors: David
authors: D
authors: Cella
authors: James L
authors: JL
authors: Burns
authors: Daniel
authors: D
authors: Ganger
authors: Al B
authors: AB
authors: Benson
authors: Mary F
authors: MF
authors: Mulcahy
authors: Laura
authors: L
authors: Kulik
authors: Robert
authors: R
authors: Lewandowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000523:psychology* / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D016896:Treatment Outcome
keywords: BCLC; Barcelona Clinic Liver Cancer; Comparison; ES; ESS; FACT; FACT-Hep; Functional Assessment of Cancer Therapy; Functional Assessment of Cancer Therapy–Hepatobiliary; HCC; Liver Cancer; Outcomes; PES; QoL; TACE; Therapy; UNOS; United Network for Organ Sharing; effect size; embolotherapy-specific score; hepatocellular carcinoma; postembolization syndrome; quality of life; transarterial chemoembolization