9:20 AM Abstract No. 69 - Quality of life in patients with hepatic malignancies treated with Holmium-166 radioembolization

Abstract

Purpose Quality of life (QoL) is an important outcome measure for palliative treatment options like radioembolization (RE) of liver tumors. Several studies have shown a trend towards a decrease in overall QoL after 90Y RE (1-6). The purpose of this study was to evaluate the QoL after RE with 166Ho microspheres; a new imageable particle for RE. Materials and Methods QoL was evaluated in patients with unresectable, chemorefractory liver metastases who were enrolled in a phase 1 dose-escalation clinical trial (7). Patients were enrolled between November 30, 2009 and September 19, 2011. Patients were treated with 166Ho RE in cohorts of three patients with escalating whole-liver absorbed doses of 20, 40, 60 and 80 Gy. QoL was assessed using the global health status and QoL score of the validated European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-LMC21 questionnaires at baseline and at 6 and 12 weeks after treatment. Results 15 patients underwent 166Ho RE. QoL could be assessed in 14 patients, because one patient developed brain metastases and did not comply with follow-up. Compared with baseline values, the mean QoL score at 6 weeks after treatment had decreased by 13 points for the whole group (from 75.6 to 62.5, p=0.053) and by 14 points at 12 weeks to a mean score of 61.9 (p=0.048). There was a difference in decrease in QoL scores between patients with progressive disease and patients with response to treatment, favouring responders, respectively -18.8 versus -5.6 points at 6 weeks (p=0.31). Decrease in QoL scores was most prominent in high dose cohorts: -8 (20 Gy), 3 (40 Gy), -13 (60 Gy), -39 (80 Gy) at 6 weeks. Conclusion Overall QoL decreased in patients with liver metastases after treatment with 166Ho RE. Patients with progressive disease and patients treated with high liver absorbed doses show the greatest decrease in QoL.