Nima Kokabi MD, Presenter: Nothing to Disclose

Minzhi Xing MD, Abstract Co-Author: Nothing to Disclose

Juan Camilo Camacho, Abstract Co-Author: Nothing to Disclose

Faramarz Edalat MD, Abstract Co-Author: Nothing to Disclose

Hyun Sik Kim MD, Abstract Co-Author: Nothing to Disclose

To investigate the effects of Y90 radioembolization on health-related quality of life (HRQOL) in patients with infiltrative hepatocellular carcinoma (HCC) and portal vein thrombosis (PVT) and to correlate baseline and early QOL trends to disease progression and survival.

HRQOL trends using Short-Form 36 (SF-36) questionnaire in patients with infiltrative HCC and PVT treated with glass-based Y90 were investigated in a correlative study related to a prospective phase II trial. Patients underwent baseline assessment within 1 mo prior to Y90 and follow-up assessments were performed at 1, 3 and 6 mo post-therapy. Tumor progression was determined by 3 monthly MRI’s. Overall survival (OS) and time to progression (TTP) were measured using Kaplan-Meier estimation from the day of first Y90. Baseline and follow-up SF-36 scores were compared using paired t-test. Log-rank test was used to determine the effects of favorable scores at baseline and early follow-ups on TTP and OS.

Thirsty patients (n=30) were treated and followed for a median of 19 mo. Decreased pre-treatment baseline scores within all domains of SF-36 were observed in patients vs. age-adjusted US controls. The physical component scores were more significantly decreased than mental components. Overall, at 1, 3 and 6 mo, scores for individual SF-36 domains, physical and mental component summaries (PCS & MCS) remained unchanged. While there was no difference in baseline SF-36 scores for patients with prolonged TTP (≥4 mo) and OS (≥6 mo), corresponding physical component scores at 1 mo were significantly higher than those with TTP < 4mo and OS <6 mo. Specifically at 1 mo, patients with normalized Physical Function, Role Physical and PCS within 2 standard deviation (SD) of US normalized score, had a significantly prolonged median OS (15.7 mo vs. 3.7 mo; p<0.001) and TTP (12.4 mo vs. 1.8 mo; p<0.001) compared those with physical component scores >2SD below normalized US population values.

HRQOL in patients treated with infiltrative HCC and PVT treated with Y90 does not significantly change within 6 months post therapy. Early (1month) favorable trends in the physical components of SF-36 may be a predictor of prolonged OS and TTP.

The effect of Y90 radioembolization on HRQOL in patients with infilitrative HCC and PVT and the utlility of SF-36 assessment tool as a predictor of clinical outcome are currently unknown. 

Kokabi, N, Xing, M, Camacho, J, Edalat, F, Kim, H, Prospective Longitudinal Quality of Life Assessment in Patients with Unresectable Infiltrative Hepatocellular Carcinoma and Portal Vein Thrombosis after Yttrium-90 Radioembolization and Outcome Correlations.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009430.html