nach oben

Journal of Cancer Research and Clinical Oncology

Erschienen in:

14.07.2018 | Original Article – Clinical Oncology

Quality of life in patients undergoing repetitive TACE for the treatment of intermediate stage HCC

verfasst von: K. J. Hartrumpf, S. Marquardt, T. Werncke, T. Murray, M. M. Kirstein, A. Vogel, F. Wacker, T. Rodt

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 10/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

With a limited overall survival (OS) of 20 months in patients diagnosed with intermediate stage hepatocellular carcinoma (HCC), the preservation of quality of life (QoL) during transarterial chemoembolization (TACE) procedures remains a primary goal. The aim of our study was to evaluate the change in QoL amongst patients undergoing repetitive TACE and to identify specific risk factors that may predict change in QoL.

Methods

QoL was assessed in 82 patients undergoing at least two TACE, before and 14 days after TACE, using validated EORTC QLQ-C30 and EORTC HCC18 questionnaires. Tumour response was assessed using established response criteria. Laboratory and clinical parameters were analysed.

Results

Functional scores decreased due to first TACE treatment (p < 0.01), conversely symptom scores increased significantly (p < 0.01). During repetitive TACE no statistically significant changes were observed. Higher Global Health- and Physical Functioning scores at baseline were identified as independent prognostic factors for greater decrease in QoL. Tumour response did not alter QoL at all. Furthermore higher symptom scales including pain (p = 0.00), nausea and vomiting (p = 0.00) and fever (p < 0.01 for repetitive TACE) at baseline were predictive of a significantly lesser increase of symptom severity, and a greater reduction in pain during a course of TACE. Higher C-reactive protein (CRP) at baseline and female gender were associated with a greater decrease of functional scales and increase of symptom scales.

Conclusion

QoL amongst patients receiving repetitive TACE showed neither significant nor clinically relevant changes over time. Pre-treatment assessment of QoL-scores, clinical and laboratory parameters can improve patient selection for TACE whilst optimizing QoL.

Nur mit Berechtigung zugänglich

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 85:365–376CrossRefPubMed

Ahmed S, de Souza NN, Qiao W et al (2016) Quality of life in hepatocellular carcinoma patients treated with transarterial chemoembolization. HPB Surg. https://doi.org/10.1155/2016/6120143 CrossRefPubMedPubMedCentral

Aliberti C, Carandina R, Sarti D et al (2017) Chemoembolization adopting polyethylene glycol drug-eluting embolics loaded with doxorubicin for the treatment of hepatocellular carcinoma. AJR Am J Roentgenol 209:430–434. https://doi.org/10.2214/AJR.16.17477 CrossRefPubMed

Anota A, Boulin M, Dabakuyo-Yonli S et al (2016) An explorative study to assess the association between health-related quality of life and the recommended phase II dose in a phase I trial: idarubicin-loaded beads for chemoembolisation of hepatocellular carcinoma. BMJ Open 6:e010696. https://doi.org/10.1136/bmjopen-2015-010696 CrossRefPubMedPubMedCentral

Blazeby JM, Currie E, Zee BC 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 40:2439–2444. https://doi.org/10.1016/j.ejca.2004.06.033 CrossRefPubMed

Bosch FX, Ribes J, Diaz M, Cleries R (2004) Primary liver cancer: worldwide incidence and trends. Gastroenterology 127:S5–S16CrossRefPubMed

Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol 35:421–430CrossRef

Bruix J, Sherman M, American Association for the Study of Liver D (2011) Management of hepatocellular carcinoma: an update. Hepatology 53:1020–1022. https://doi.org/10.1002/hep.24199 CrossRefPubMed

Chie WC, Blazeby JM, Hsiao CF 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 55:1122–1129. https://doi.org/10.1002/hep.24798 CrossRefPubMed

Chie W-C, Yu F, Li M et al (2015) Quality of life changes in patients undergoing treatment for hepatocellular carcinoma. Qual Life Res Int J Qual Life Asp Treat Care Rehabil 24:2499–2506. https://doi.org/10.1007/s11136-015-0985-8 CrossRef

Chow PKH, Gandhi M, Tan S-B et al (2018) SIRveNIB: selective internal radiation therapy versus sorafenib in Asia-Pacific patients with hepatocellular carcinoma. J Clin Oncol Off J Am Soc Clin Oncol JCO2017760892. https://doi.org/10.1200/JCO.2017.76.0892 CrossRefPubMed

Cucchetti A, Trevisani F, Cappelli A et al (2016) Cost-effectiveness of doxorubicin-eluting beads versus conventional trans-arterial chemo-embolization for hepatocellular carcinoma. Dig Liver Dis 48:798–805. https://doi.org/10.1016/j.dld.2016.03.031 CrossRefPubMed

Eisenhauer EA, Therasse P, Bogaerts J et al (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer Oxf Engl 1990 45:228–247. https://doi.org/10.1016/j.ejca.2008.10.026 CrossRef

El-Serag HB, Rudolph KL (2007) Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology 132:2557–2576. https://doi.org/10.1053/j.gastro.2007.04.061 CrossRefPubMed

Eltawil KM, 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 14:341–350. https://doi.org/10.1111/j.1477-2574.2012.00455.x CrossRefPubMedPubMedCentral

European Association For The Study Of The L, European Organisation For R, Treatment Of C (2012) EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 56:908–943. https://doi.org/10.1016/j.jhep.2011.12.001 CrossRef

Fayers PM, Aaronson NK, Bjordal K et al (2001) The EORTC QLQ-C30 Scoring Manual (3rd Edition). Eur Organ Res Treat Cancer

Gandhi S, Khubchandani S, Iyer R (2014) Quality of life and hepatocellular carcinoma. J Gastrointest Oncol 5:296–317. https://doi.org/10.3978/j.issn.2078-6891.2014.046 CrossRefPubMedPubMedCentral

Heffernan N, Cella D, Webster K et al (2002) Measuring health-related quality of life in patients with hepatobiliary cancers: the functional assessment of cancer therapy-hepatobiliary questionnaire. J Clin Oncol 20:2229–2239CrossRefPubMed

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 Interv Radiol. https://doi.org/10.1007/s00270-017-1681-6 CrossRefPubMed

Kaiser K, Mallick R, Butt Z et al (2014) Important and relevant symptoms including pain concerns in hepatocellular carcinoma (HCC): a patient interview study. Support Care Cancer 22:919–926. https://doi.org/10.1007/s00520-013-2039-5 CrossRefPubMed

Kamath PS, Wiesner RH, Malinchoc M et al (2001) A model to predict survival in patients with end-stage liver disease. Hepatology 33:464–470. https://doi.org/10.1053/jhep.2001.22172 CrossRefPubMed

Kavadas V, Blazeby JM, Conroy T et al (2003) Development of an EORTC disease-specific quality of life questionnaire for use in patients with liver metastases from colorectal cancer. Eur J Cancer 39:1259–1263CrossRefPubMed

Kolligs FT, Bilbao JI, Jakobs T et al (2015) Pilot randomized trial of selective internal radiation therapy vs. chemoembolization in unresectable hepatocellular carcinoma. Liver Int 35:1715–1721. https://doi.org/10.1111/liv.12750 CrossRefPubMed

Lencioni R, Llovet JM (2010) Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis 30:52–60. https://doi.org/10.1055/s-0030-1247132 CrossRefPubMed

Lencioni R, Montal R, Torres F et al (2017) Objective response by mRECIST as a predictor and potential surrogate end-point of overall survival in advanced HCC. J Hepatol 66:1166–1172. https://doi.org/10.1016/j.jhep.2017.01.012 CrossRefPubMed

Llovet JM, Bruix J (2003) Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival. Hepatology 37:429–442. https://doi.org/10.1053/jhep.2003.50047 CrossRefPubMed

Llovet JM, Bruix J (2008) Molecular targeted therapies in hepatocellular carcinoma. Hepatology 48:1312–1327. https://doi.org/10.1002/hep.22506 CrossRefPubMed

Lu W, Jin XL, Yang C et al (2017) Comparison of efficacy between TACE combined with apatinib and TACE alone in the treatment of intermediate and advanced hepatocellular carcinoma: A single-center randomized controlled trial. Cancer Biol Ther 1–6. https://doi.org/10.1080/15384047.2017.1323589 CrossRef

Mason MC, Massarweh NN, Salami A et al (2015) Post-embolization syndrome as an early predictor of overall survival after transarterial chemoembolization for hepatocellular carcinoma. HPB 17:1137–1144. https://doi.org/10.1111/hpb.12487 CrossRefPubMedPubMedCentral

Miller AB, Hoogstraten B, Staquet M, Winkler A (1981) Reporting results of cancer treatment. Cancer 47:207–214CrossRefPubMed

Oliveri RS, Wetterslev J, Gluud C (2011) Transarterial (chemo)embolisation for unresectable hepatocellular carcinoma. Cochrane Database Syst Rev CD004787. https://doi.org/10.1002/14651858.CD004787.pub2

Osoba D, Rodrigues G, Myles J et al (1998) Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol 16:139–144. https://doi.org/10.1200/JCO.1998.16.1.139 CrossRefPubMed

Qiao C-X, Zhai X-F, Ling C-Q et al (2012) Health-related quality of life evaluated by tumor node metastasis staging system in patients with hepatocellular carcinoma. World J Gastroenterol WJG 18:2689–2694. https://doi.org/10.3748/wjg.v18.i21.2689 CrossRefPubMed

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 11:1358–1365 e1. https://doi.org/10.1016/j.cgh.2013.04.028 CrossRefPubMed

Shun SC, Chen CH, Sheu JC et al (2012) Quality of life and its associated factors in patients with hepatocellular carcinoma receiving one course of transarterial chemoembolization treatment: a longitudinal study. Oncologist 17:732–739. https://doi.org/10.1634/theoncologist.2011-0368 CrossRefPubMedPubMedCentral

Takayasu K, Arii S, Ikai I et al (2006) Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients. Gastroenterology 131:461–469. https://doi.org/10.1053/j.gastro.2006.05.021 CrossRefPubMed

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:e23–e30. https://doi.org/10.1016/j.suronc.2011.10.005 CrossRefPubMed

Varela M, Real MI, Burrel M et al (2007) Chemoembolization of hepatocellular carcinoma with drug eluting beads: efficacy and doxorubicin pharmacokinetics. J Hepatol 46:474–481. https://doi.org/10.1016/j.jhep.2006.10.020 CrossRefPubMed

Vilgrain V, Pereira H, Assenat E et al (2017) Efficacy and safety of selective internal radiotherapy with yttrium-90 resin microspheres compared with sorafenib in locally advanced and inoperable hepatocellular carcinoma (SARAH): an open-label randomised controlled phase 3 trial. Lancet Oncol 18:1624–1636. https://doi.org/10.1016/S1470-2045(17)30683-6 CrossRefPubMed

Vincenzi B, Di Maio M, Silletta M et al (2015) Prognostic Relevance of Objective Response According to EASL Criteria and mRECIST Criteria in Hepatocellular Carcinoma Patients Treated with Loco-Regional Therapies: A Literature-Based Meta-Analysis. PLoS One 10:e0133488. https://doi.org/10.1371/journal.pone.0133488 CrossRefPubMedPubMedCentral

Wang YB, Chen MH, 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 16:389–397. https://doi.org/10.1007/s11136-006-9133-9 CrossRefPubMed

Ware JE (2000) SF-36 health survey update. Spine Phila Pa 1976 25:3130–3139CrossRef

Wible BC, Rilling WS, Drescher P et al (2010) Longitudinal quality of life assessment of patients with hepatocellular carcinoma after primary transarterial chemoembolization. J Vasc Interv Radiol 21:1024–1030. https://doi.org/10.1016/j.jvir.2010.03.005 CrossRefPubMed

World Health Organization (2017) WHO’s cancer pain ladder for adults

Xie ZB, Wang XB, Peng YC et al (2015) Systematic review comparing the safety and efficacy of conventional and drug-eluting bead transarterial chemoembolization for inoperable hepatocellular carcinoma. Hepatol Res 45:190–200. https://doi.org/10.1111/hepr.12450 CrossRefPubMed

Yu SJ, Kim YJ (2015) Effective treatment strategies other than sorafenib for the patients with advanced hepatocellular carcinoma invading portal vein. World J Hepatol 7:1553–1561. https://doi.org/10.4254/wjh.v7.i11.1553 CrossRefPubMedPubMedCentral

Zheng Z, Zhou L, Gao S et al (2013) Prognostic role of C-reactive protein in hepatocellular carcinoma: a systematic review and meta-analysis. Int J Med Sci 10:653–664. https://doi.org/10.7150/ijms.6050 CrossRefPubMedPubMedCentral

Zou JH, Zhang L, Ren ZG, Ye SL (2016) Efficacy and safety of cTACE versus DEB-TACE in patients with hepatocellular carcinoma: a meta-analysis. J Dig Dis 17:510–517. https://doi.org/10.1111/1751-2980.12380 CrossRefPubMed

The WHOQOL Group (1998) Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 28:551–8

Titel: Quality of life in patients undergoing repetitive TACE for the treatment of intermediate stage HCC
verfasst von: K. J. Hartrumpf
S. Marquardt
T. Werncke
T. Murray
M. M. Kirstein
A. Vogel
F. Wacker
T. Rodt
Publikationsdatum: 14.07.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 10/2018
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-018-2704-7

Neu im Fachgebiet Onkologie

23.04.2024 | Medikamente in Schwangerschaft und Stillzeit | Nachrichten

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Quality of life in patients undergoing repetitive TACE for the treatment of intermediate stage HCC

Abstract

Purpose

Methods

Results

Conclusion

Neu im Fachgebiet Onkologie

ICI-Therapie in der Schwangerschaft wird gut toleriert

Krebspatienten impfen: Was? Wen? Und wann nicht?

Müde im Alter? Auch an die Nebenniere denken

Stufenschema weist Prostatakarzinom zuverlässig nach

Update Onkologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 10/2018

Use and perception of complementary and alternative medicine among cancer patients: the CAMEO-PRO study

Expressional profiling and clinical relevance of RNase κ in prostate cancer: a novel indicator of favorable progression-free survival

Protective immunity elicited by measles vaccine exerts anti-tumor effects on measles virus hemagglutinin gene-modified cancer cells in a mouse model

Diverging impact of cell fate determinants Scrib and Llgl1 on adhesion and migration of hematopoietic stem cells

Is there a benefit of lymphadenectomy for overall and recurrence-free survival in type I FIGO IB G1-2 endometrial carcinoma? A retrospective population-based cohort analysis

Endometrial cancer subtypes are associated with different patterns of recurrence

Neu im Fachgebiet Onkologie

ICI-Therapie in der Schwangerschaft wird gut toleriert

Krebspatienten impfen: Was? Wen? Und wann nicht?

Müde im Alter? Auch an die Nebenniere denken

Stufenschema weist Prostatakarzinom zuverlässig nach

Update Onkologie