Effect of Transarterial Chemoembolization on Health-Related Quality of Life in Patients With Hepatocellular Carcinoma.

BACKGROUND AND AIM

We evaluated health-related quality of life (HRQoL) in patients with hepatocellular carcinoma (HCC) before and after transarterial chemoembolization (TACE) and the clinical and biochemical factors that can predict changes in quality of life (QoL).

METHODS

A total of 45 patients were enrolled in the study and followed up for a period of three months. HRQoL was assessed using an HCC-specific questionnaire at baseline, two weeks, and three months. Tumor response was evaluated at six weeks using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria.

RESULTS

Before TACE, the aspects of the functional scales most significantly impacted were global health status (53.1±29.3%) and physical functioning (68.7±20.7%). The commonly reported symptoms and their corresponding QoL scores were as follows: fatigue (46.4±32.5%), followed by insomnia (32.6±36.6%) and abdominal pain (32.2±30.8%). Financial constraints (63.0±37.1%) were also a significant concern for the patients. Most functional and symptom scores showed a reduction at two weeks and improvement at three months. Global health status improved to 68±28.2% (p=0.455), whereas physical functioning improved to 73.8±23.2% (p=0.005) at three months following TACE. After three months following TACE, the QoL scores for the following symptoms improved from baseline: fatigue (30.5±28.2; p=0.012), insomnia (25.9±27.4; p=0.896), and pain (28.5±30.8; p=0.005). High alpha-fetoprotein (AFP), high C-reactive protein (CRP), low albumin, and an increase in Model for End-stage Liver Disease (MELD) and Child-Turcotte-Pugh (CTP) scores were found to have a negative impact at three months. Following TACE, 26 (57%), nine (20%), three (7%), and seven (16%) patients had complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD), respectively. Quality of life scores showed a positive response at three months in subjects with CR, PR, and SD, while in those with PD, QoL continued to deteriorate over time.

CONCLUSION

Effective symptom management, along with the implementation of coping strategies to improve functionality, is crucial when caring for patients who have undergone TACE, particularly during the first two weeks post-procedure.