Bress Kathryn, Bou-Samra Patrick, Kallem Cramer J, Tsung Allan, Gammer Ellie, Geller David A, Marsh James W, Steel Jennifer L
Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
J Egypt Natl Canc Inst. 2025 Apr 14;37(1):11. doi: 10.1186/s43046-025-00267-1.
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. Due to the advanced stage in which HCC presents, most patients are only eligible for transarterial chemoembolization (TACE) or radioembolization (Y). The purpose of this study is to examine the differences in survival and health-related quality of life (HRQOL) in patients diagnosed with HCC and treated with TACE or Y.
Two hundred thirty-four patients with HCC were enrolled in studies examining HRQOL between 2003-2009. HRQOL was evaluated using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep). Between-group differences were examined using chi-square and ANOVA. Survival was assessed using Kaplan-Meier and Cox regression analyses.
Significant baseline differences between patients treated with TACE versus Y were found. Patients who received Y tended to be older (p < 0.001), female (p < 0.001), had fewer lesions (p = 0.03), had smaller tumors (p = 0.03), and were less likely to have vascular invasion (p = 0.04). After adjusting for demographic and disease-specific factors, no significant differences in HRQOL were observed at 3 months (p = 0.79) or 6 months (p = 0.75). Clinically meaningful differences were found, with the TACE group reporting greater physical, social, and emotional well-being at 3 and 6 months and greater overall HRQOL at 6 months. No significant differences in survival were found.
Treatment with TACE and Y was similar with regard to survival. However, TACE showed statistically and clinically meaningful benefits in physical, social/family, and emotional well-being. Further research is warranted to identify profiles of patients who may demonstrate a preferential response to either TACE or Y.
肝细胞癌（HCC）是全球第五大常见癌症。由于HCC多在晚期出现，大多数患者仅适合接受经动脉化疗栓塞术（TACE）或放射性栓塞术（Y）。本研究的目的是探讨诊断为HCC并接受TACE或Y治疗的患者在生存及健康相关生活质量（HRQOL）方面的差异。
234例HCC患者纳入了2003年至2009年期间关于HRQOL的研究。使用癌症治疗功能评估-肝胆量表（FACT-Hep）评估HRQOL。采用卡方检验和方差分析检查组间差异。使用Kaplan-Meier法和Cox回归分析评估生存情况。
发现接受TACE与Y治疗的患者在基线存在显著差异。接受Y治疗的患者往往年龄较大（p<0.001）、为女性（p<0.001）、病灶较少（p=0.03）、肿瘤较小（p=0.03），且血管侵犯的可能性较小（p=0.04）。在调整人口统计学和疾病特异性因素后，3个月（p=0.79）或6个月（p=0.75）时HRQOL未观察到显著差异。发现了具有临床意义的差异，TACE组在3个月和6个月时报告的身体、社交和情感幸福感更高，在6个月时总体HRQOL更高。生存方面未发现显著差异。
TACE和Y治疗在生存方面相似。然而，TACE在身体、社交/家庭和情感幸福感方面显示出统计学和临床意义上的益处。有必要进一步研究以确定可能对TACE或Y有优先反应的患者特征。
