Quality of life in patients with liver tumors treated with holmium-166 radioembolization

Caren van Roekel,Maurice A. A. J. van den Bosch,Rutger C. G. Bruijnen,Jip F. Prince,Marnix G. E. H. Lam,Maarten L. J. Smits

doi:10.1007/s10585-019-10006-1

Caren van Roekel, Maurice A. A. J. van den Bosch + Show 4 more

Open Access

https://doi.org/10.1007/s10585-019-10006-1

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Abstract

Holmium-166 radioembolization is a palliative treatment option for patients with unresectable hepatic malignancies. Its influence on quality of life has not been evaluated yet. Since quality of life is very important in the final stages of disease, the aim of this study was to evaluate the effect of holmium-166 radioembolization on quality of life. Patients with hepatic malignancies were treated with holmium-166 radioembolization in the HEPAR I and II studies. The European Organization for Research and Treatment of Cancer QLQ-C30 and LMC21 questionnaires were used to evaluate quality of life at baseline, 1 week, 6 weeks and at 6, 9 and 12 months after treatment. The course of the global health status and symptom and functioning scales were analyzed using a linear mixed model. Quality of life was studied in a total of 53 patients with a compliance of 94%. Role functioning was the most affected functioning scale. Fatigue and pain were the most affected symptom scales. Changes in almost all categories were most notable at 1 week after treatment. A higher WHO performance score at baseline decreased global health status, physical functioning, role functioning and social functioning and it increased symptoms of fatigue, dyspnea and diarrhea. Quality of life in salvage patients with liver metastases treated with holmium-166 radioembolization was not significantly affected over time, although a striking decline was seen during the first week post-treatment. A WHO performance score > 0 at baseline significantly influenced quality of life.

Highlights

Abbreviations 90Y Yttrium-90 99mTc-MAA Technetium 99mTc macro-aggregated albumin 166Ho Holmium-166 appetite loss (AP) Appetite loss cognitive functioning (CF) Cognitive functioning CO Constipation DI Diarrhoea DY Dyspnoea emotional functioning (EF) Emotional functioning
quality of life (QoL) was studied in a total of 53 patients treated with 166HoRE between November 2009 and March 2015; 15 patients in the HEPAR I study and 38 patients in the HEPAR II study (Flowchart for study inclusions: Figure S2)
This study showed that the first hypothesis was correct: QoL was not significantly affected over time, there was a lot of variation between and within patients

Summary

Introduction

Abbreviations 90Y Yttrium-90 99mTc-MAA Technetium 99mTc macro-aggregated albumin 166Ho Holmium-166 AP Appetite loss CF Cognitive functioning CO Constipation DI Diarrhoea DY Dyspnoea EF Emotional functioning. FA Fatigue FI Financial difficulties GHS Global health status HCC Hepatocellular carcinoma LMCDM Dry mouth LMCEp Emotional problems LMCFati Fatigue LMCFeelings Talking about feelings LMCFr Contact with friends LMCJ Jaundice LMCPA Pain LMCPN Peripheral neuropathy LMCSM Sore mouth/tongue LMCSx Sex life LMCTA Taste LMCWL Weight loss LMNutri Eating MRI Magnetic resonance imaging NV Nausea and vomiting. PA Pain PF Physical functioning QoL Quality of life RE Radioembolization RECIST 1.1 Response Evaluation Criteria In Solid. The purpose of the current study was to evaluate the effect of 166Ho-RE on QoL. Our hypothesis was that QoL would not be significantly affected by 166HoRE, similar to what is known for 90Y-RE. The hypothesis was that QoL may be impaired by the known short-term side-effects of 90Y-RE, i.e. the post-embolization syndrome

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