Association of adverse events and quality of life in patients with unresectable hepatocellular carcinoma.

IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Quality of Life Research Pub Date : 2024-10-16 DOI:10.1007/s11136-024-03779-w
Ion Agirrezabal, Richard F Pollock, Phuong Lien Carion, Suki Shergill, Victoria K Brennan, Helena Pereira, Gilles Chatellier, Valérie Vilgrain
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Abstract

Purpose: Hepatocellular carcinoma (HCC) is the third-leading cause of cancer-related deaths globally. Patients are often diagnosed with advanced disease, in which systemic and locoregional therapies are commonly used as first-line treatment. Such treatments can cause adverse events (AEs) that negatively affect quality of life (QoL), which is particularly undesirable where prognosis is poor. The aim of the present study was to evaluate the impact of common AEs on QoL in patients with HCC.

Methods: Data from the SARAH randomized controlled trial (RCT) were analyzed. Given the large number of distinct AEs that occurred in the trial, AEs were grouped as in the SARAH trial and prioritized using principal component analysis (PCA). Linear mixed-effects models were then applied with age, ECOG status, and AEs as predictors of the QoL change as measured with the EORTC Core Quality of Life Questionnaire (QLQ-C30).

Results: The PCA resulted in the selection of 28 AEs for inclusion in the linear mixed-effects models. Of the 28 AEs, diarrhea, decreased appetite, abdominal pain, and palmar-plantar erythrodysesthesia syndrome (hand-foot syndrome) were significant drivers of reductions in QoL as measured using the QLQ-C30 global health status scale. Diarrhea, abdominal pain, and hand-foot syndrome were also significant drivers of reduced QoL outcomes.

Conclusion: The present analysis showed that diarrhea, decreased appetite, abdominal pain, and palmar-plantar erythrodysesthesia were significantly associated with reduced QoL in patients with unresectable HCC. Reducing the incidence and/or severity of these AEs should therefore be a key focus when selecting the optimal treatments for these patients.

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不可切除肝细胞癌患者不良事件与生活质量的关系
目的:肝细胞癌(HCC)是全球癌症相关死亡的第三大原因。患者通常被诊断为晚期疾病,全身和局部治疗通常被用作一线治疗。这些治疗方法可能会导致不良事件(AE),对生活质量(QoL)造成负面影响,尤其是在预后较差的情况下更不可取。本研究旨在评估常见 AE 对 HCC 患者 QoL 的影响:分析了 SARAH 随机对照试验(RCT)的数据。鉴于试验中出现了大量不同的AEs,我们按照SARAH试验中的方法对AEs进行了分组,并使用主成分分析(PCA)对其进行了优先排序。然后应用线性混合效应模型,将年龄、ECOG 状态和 AEs 作为通过 EORTC 核心生活质量问卷(QLQ-C30)测量的 QoL 变化的预测因子:通过 PCA 筛选出 28 种 AE 纳入线性混合效应模型。在这 28 种 AE 中,腹泻、食欲下降、腹痛和掌跖红肿综合征(手足综合征)是导致 QoL 下降的重要因素,QoL 是使用 QLQ-C30 全球健康状况量表进行测量的。腹泻、腹痛和手足综合征也是导致 QoL 下降的重要因素:本分析显示,腹泻、食欲减退、腹痛和掌跖红斑性肢痛与不可切除的 HCC 患者的 QoL 降低有显著相关性。因此,在为这些患者选择最佳治疗方法时,降低这些不良反应的发生率和/或严重程度应成为重点。
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来源期刊
Quality of Life Research
Quality of Life Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
8.60%
发文量
224
审稿时长
3-8 weeks
期刊介绍: Quality of Life Research is an international, multidisciplinary journal devoted to the rapid communication of original research, theoretical articles and methodological reports related to the field of quality of life, in all the health sciences. The journal also offers editorials, literature, book and software reviews, correspondence and abstracts of conferences. Quality of life has become a prominent issue in biometry, philosophy, social science, clinical medicine, health services and outcomes research. The journal''s scope reflects the wide application of quality of life assessment and research in the biological and social sciences. All original work is subject to peer review for originality, scientific quality and relevance to a broad readership. This is an official journal of the International Society of Quality of Life Research.
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