Does Y90 Impact QOL in the Long Term?
Treatment with yttrium-90 (Y-90) radioembolization improves health-related quality of life (HRQOL) over the long term, according to a recent study.
The prospective study involved 30 consecutive patients with unresectable infiltrative hepatocellular carcinoma (HCC) with concurrent portal vein thrombosis (PVT). HRQOL was assessed with the Short-Form 36 (SF-36) questionnaire for patients who received glass-based Y-90 based on a prospective phase II trial. Tumor progression was assessed using magnetic resonance (MR) imaging every 3 months following treatment, and patients were followed for a median of 17.4 months. Overall survival and time to progression were also evaluated as part of the study.
After treatment, physical and mental component summary scores remained the same at 1, 3, and 6-month follow up. There was no difference identified in baseline SF-36 scores for patients with TTP ≥4 months and OS < 6 months, but these patients had corresponding 1-month physical component summary scores that were significantly higher than the scores of patients with TTP < 4 months and OS < 6 months.
Additionally, patients with normalized Physical Function (PF), Role Physical (RP) and PCS within 2 standard deviations (SD) of US normalized baseline scores had a median OS of 15.7 months and TTP of 12.4 months, while patients with physical component scores greater than 2SD below normalized US population values had a median OS of 3.7 months and TTP of 1.8 months. These differences were significant and were seen at 1 month.
“In summary, our study demonstrated that health-related quality of life was preserved in the short- and medium-term for patients who received 90Y radioembolization for infiltrative, advanced HCC with PVT,” the researchers wrote. They added, “Lower baseline HRQOL scores were predictive of poorer OS. Early (1 month post-treatment) significant decreases in PCS were independent predictors of poorer OS and TTP.”
Xing M, Kokabi N, Camacho JC, Kim HS. Prospective longitudinal quality of life and survival outcomes in patients with advanced infiltrative hepatocellular carcinoma and portal vein thrombosis treated with Yttrium-90 radioembolization. BMC Cancer. 2018 Jan 12;18(1):75. doi: 10.1186/s12885-017-3921-1.