April 11, 2011 (Chicago, Illinois) — Patients with hepatocellular carcinoma (HCC) treated with yttrium-90 (Y90) scored better than patients treated with transarterial chemoembolization (TACE) on the following mental quality-of-life (QOL) indicators: closeness to partner, closeness to friends, coping with illness, acceptance of illness, and enjoyment of life.
These results were presented by Riad Salem, MD, MBA, FSIR, professor of radiology, medicine, and surgery, and director of interventional radiology at Northwestern University in Chicago, Illinois, here at the Society of Interventional Radiology 36th Annual Scientific Meeting.
The study involved 50 patients who underwent Y90 or TACE between May 2007 and June 2009. Patients receiving Y90 scored lower than patients receiving TACE (P < .05) on the following physical QOL indicators: diarrhea, fevers, chills, adverse effects, and anorexia. There were no differences in responses between men and women. There was no statistical difference between the Y90 and TACE groups in pain, nausea, jaundice, fatigue, weight loss, ability to work, or general QOL satisfaction.
In most cases, patients with HCC receive palliative treatment to control disease and to limit the effects of the disease on QOL and function. Dr. Salem explained to Medscape Medical News that "preliminarily, it does appear that the QOL is better preserved with Y90 over chemoembolization." He noted, however, that it is still too early to recommend Y90 as a primary treatment in this patient population because the data are still being accumulated.
William S. Rilling, MD, FSIR, professor of radiology and surgery and director of vascular and interventional radiology at the Medical College of Wisconsin, in Milwaukee, is not affiliated with this study but has published research demonstrating good preservation of QOL in patients with advanced HCC who received TACE. He explained to Medscape Medical News that "the results are not surprising at all. We treat a large number of patients with both Y90 and TACE, and most patients have fewer symptoms with Y90 than conventional TACE. The study is interesting in that many of the significant differences were seen in mental (not physical) QOL indicators. In practice, we know that some patients will tolerate Y90 better than TACE." He added: "I do not think that this study suggests that Y90 should be used over TACE, but rather that QOL should be considered when selecting therapy for patients with HCC and other liver cancers."
Dr. Salem has disclosed no relevant financial relationships. Dr. Rilling reports receiving research support for clinical trials involving drug-eluting bead TACE from Biocompatibles and research support from Sirtex for a Y90 clinical trial.
Society of Interventional Radiology (SIR) 36th Annual Scientific Meeting: Abstract 182. Presented March 29, 2011.
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Cite this: Better QOL With Yttrium-90 Than TACE for Liver Cancer - Medscape - Apr 11, 2011.