Quality of life assessment for patients undergoing irreversible electroporation (IRE) for treatment of locally advanced pancreatic cancer (LAPC)

Am J Surg. 2019 Sep;218(3):571-578. doi: 10.1016/j.amjsurg.2019.03.020. Epub 2019 Apr 1.

Abstract

Background: IRE is a non-thermal ablative modality that has been shown to be safe and efficacious in LAPC and liver tumors, but few studies have shown its effects on patients' (QOL). The goal of this study is to evaluate quality-of-life (QOL) before and after irreversible electroporation (IRE) therapy for treatment of locally advanced pancreatic carcinoma (LAPC).

Methods: Between 11/2014 and 12/2016, patients scheduled for IRE therapy for LAPC were offered QOL questionnaires (EORTC QLQ-C30 V2.0) before surgery and 1,3 and 6-months after surgery. Descriptive statistics, one-way ANOVA and effect-size calculations were used in analysis of the 15 modules.

Results: Eight-four prospective patients were enrolled with a median age of 59.08 years (range 27.38-75.72) all who completed 6 months QOL surveys. Global health status scale showed lower average score at 3 and 6 months(p = 0.001). Symptoms scales constipation and insomnia showed higher averages at 3 months (p = 0.007 and p = 0.003 respectively), while dyspnea had higher average at 6 months (p < 0.001). Finally, changes were noted with worse diarrhea symptoms scale at 1 and 3 months (p < 0.001). Otherwise all QOL side effects were normalized at 3 months after IRE.

Conclusions: The preponderance of symptoms at 3-6 months, symptom profile, and the use of additional therapy on majority of patients suggests other interrelated clinical factors influenced results (e.g. chemotherapy toxicity). This demonstrates that IRE therapy does not adversely affect QOL in the short term in patients with LAPC.

MeSH terms

  • Adult
  • Aged
  • Electrochemotherapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / pathology
  • Prospective Studies
  • Quality of Life*
  • Self Report