Comparison of health-related quality of life after transarterial chemoembolization and transarterial radioembolization in patients with unresectable hepatocellular carcinoma
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.
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.
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.
KeywordsHepatocellular carcinoma Transarterial therapies Transarterial chemoembolization Transarterial radioembolization Palliative therapy Quality of life
Compliance with ethical standards
This study was not supported by any funding.
Conflict of interest
The authors declared that they have no conflict of interest.
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.
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.
- 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):711–714PubMedGoogle Scholar
- 12.Moinpour CM (1994) Measuring quality of life: an emerging science. Semin Oncol 5(10):48–60Google 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):1122–1129CrossRefGoogle 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.Google Scholar