Journal of Gastroenterology and Hepatology

Hepatology

Preservation of quality of life with doxorubicin drug-eluting bead transarterial chemoembolization for unresectable hepatocellular carcinoma: Longitudinal prospective study

Minzhi Xing

Interventional Radiology, Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

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Grant Webber,

Grant Webber

Division of Interventional Radiology and Image-guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA

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Hasmukh J Prajapati,

Hasmukh J Prajapati

Division of Interventional Radiology and Image-guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA

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Zhengjia Chen,

Zhengjia Chen

Department of Biostatistics and Bioinformatics, Shared Resource at Winship Cancer Institute in the Rollins School of Public Health, Atlanta, Georgia, USA

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Bassel El-Rayes,

Bassel El-Rayes

Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA

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James R Spivey,

James R Spivey

Department of Section of Hepatology, Division of Digestive Diseases, Emory University Hospital, Atlanta, Georgia, USA

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Anjana A Pillai,

Anjana A Pillai

Department of Section of Hepatology, Division of Digestive Diseases, Emory University Hospital, Atlanta, Georgia, USA

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Hyun S Kim,

Corresponding Author

Hyun S Kim

Interventional Radiology, Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

Cancer Therapeutics Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, USA

Correspondence

Dr Hyun S Kim, Interventional Radiology, Department of Radiology, University of Pittsburgh School of Medicine, Radiology Suite 201 East Wing, 200 Lothrop Street, Pittsburgh, PA 15213-3553, USA. Email: [email protected]

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Minzhi Xing,

Minzhi Xing

Interventional Radiology, Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

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Grant Webber,

Grant Webber

Division of Interventional Radiology and Image-guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA

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Hasmukh J Prajapati,

Hasmukh J Prajapati

Division of Interventional Radiology and Image-guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA

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Zhengjia Chen,

Zhengjia Chen

Department of Biostatistics and Bioinformatics, Shared Resource at Winship Cancer Institute in the Rollins School of Public Health, Atlanta, Georgia, USA

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Bassel El-Rayes,

Bassel El-Rayes

Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA

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James R Spivey,

James R Spivey

Department of Section of Hepatology, Division of Digestive Diseases, Emory University Hospital, Atlanta, Georgia, USA

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Anjana A Pillai,

Anjana A Pillai

Department of Section of Hepatology, Division of Digestive Diseases, Emory University Hospital, Atlanta, Georgia, USA

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Hyun S Kim,

Corresponding Author

Hyun S Kim

Interventional Radiology, Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

Cancer Therapeutics Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, USA

Correspondence

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First published: 13 February 2015

https://doi.org/10.1111/jgh.12920

Citations: 16

Preliminary data from this manuscript was presented at the 2012 Society of Interventional Radiology Annual Meeting.

Information concerning grants: None applicable.

Disclosures: All authors have no financial or other disclosures relationship with any commercial organization that may have a direct or indirect interest in this manuscript.

Author contributions: Minzhi Xing conducted analysis and interpretation of the data, statistical analysis, drafting of the manuscript, and critical revision of the manuscript for important intellectual content. Grant Webber was involved in acquisition of data, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content, and statistical analysis. Hasmukh J Prajapati was involved in acquisition of data, analysis and interpretation of data, and critical revision of the manuscript for important intellectual content. Zhengjia Chen was involved in the analysis and interpretation of data and statistical analysis. Bassel El-Rayes was involved in the study concept and design, drafting of the manuscript, and critical revision of the manuscript for important intellectual content. James R Spivey was involved in the study concept and design, drafting of the manuscript, and critical revision of the manuscript for important intellectual content. Anjana A Pillai was involved in the study concept and design, drafting of the manuscript, and critical revision of the manuscript for important intellectual content. Hyun S Kim was involved in study concept and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content, statistical analysis, and study overall supervision. All authors were involved in critically revising the manuscript prior to final submission.

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Abstract

Background and Aim

The study aims to determine the effects of doxorubicin drug-eluting bead transarterial chemoembolization (DEB-TACE) therapies on health-related quality of life (HRQOL) in patients with unresectable hepatocellular carcinoma (HCC).

Methods

This is a single-center, prospective study assessing HRQOL of consecutive patients with unresectable HCC who underwent DEB-TACE. Longitudinal assessment of HRQOL scores via Short-Form-36 (SF-36) was performed. Baseline HRQOL scores were evaluated for significant change (P < 0.05) pre-therapy, post-therapy, and at 6- and 12-month follow-up. Analysis of overall survival (OS) from HCC diagnosis and OS from first DEB-TACE was performed. Paired t-tests were used to compare HRQOL domain scores.

Results

One hundred eighteen patients (83 male; median age 60 years) were enrolled. Patients had lower baseline scores within all eight HRQOL domains of the SF-36 compared with US age-adjusted healthy norms. No significant changes in all eight domains were observed post-therapy and at 6- or 12-month follow-up compared with baseline (P > 0.05). No significant differences in all eight domains were observed between patients receiving ≥ 4 versus ≤ 3 DEB-TACE (P > 0.05). Both groups were similar for age at HCC diagnosis, gender, ethnicity, HCC etiology, Child–Pugh class and Eastern Cooperative Oncology Group Performance Status (P > 0.05). Patients receiving staged DEB-TACE demonstrated significantly greater median OS from HCC diagnosis (≥ 4 vs ≤ 3 DEB-TACE procedures, 31.9 vs 23.7 months, P = 0.04) and from first DEB-TACE (≥ 4 vs ≤ 3 DEB-TACE, 29.1 vs 20.2 months, P = 0.03).

Conclusion

DEB-TACE therapy for HCC demonstrated long-term preservation of HRQOL. In addition, staged DEB-TACE with four or more therapies does not significantly impact long-term HRQOL compared with patients who received three or fewer therapies.

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Volume30, Issue7

July 2015

Pages 1167-1174

Preservation of quality of life with doxorubicin drug-eluting bead transarterial chemoembolization for unresectable hepatocellular carcinoma: Longitudinal prospective study

Abstract

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Conclusion

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Preservation of quality of life with doxorubicin drug-eluting bead transarterial chemoembolization for unresectable hepatocellular carcinoma: Longitudinal prospective study

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Conclusion

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