Impact of sociodemographic characteristics and drug-related side effects on quality of life of patients with hepatocellular carcinoma receiving sorafenib treatment in Iraqi hospitals
Keywords:Hepatocellular carcinoma, Multikinase inhibitor, Quality of life, Sociodemographic, Sorafenib.
Background: Sorafenib is an oral multikinase inhibitor which has been given approval by the United States Food and Drug Administration for the treatment of patients diagnosed with hepatocellular carcinoma and advanced renal cell carcinoma . However, measuring quality of life and patient-reported symptoms may provide further information for evaluating and comparing treatment efficacy and toxicity profiles during cancer treatment. Despite the critical importance of patients' quality of life while receiving anticancer treatment, neither Iraqi patients undergoing anti-cancer medications in general nor those receiving Sorafenib in particular had any published data evaluating this important parameter.
Objectives: The study aimed to assess the quality of life of Sorafenib-treated Iraqi patients diagnosed with hepatocellular carcinoma.
Methods: A prospective, cross-sectional study was performed at the oncology clinic of (Oncology Teaching Hospital, Al-Amal Hospital and Al -Imamein Al- Kadhimein Medical City in Baghdad, Iraq) during the period from November 2021 to July 2022. Patients were enrolled in current study by using a convenient sampling method. Assessment of quality of life was performed using a questionnaire from the “European Organization for Research and Treatment of Cancer”. Statistical analyses were performed using statistical package for Social Sciences. Student’s t-test and ANOVA test were used to compare categorical data. P value of <0.05 was considered statistically significant.
Results: The present study included 52 patients in total. Of the latter, 90.4% experienced fatigue, making it the most frequent adverse event, followed by anorexia, anemia, nausea, diarrhea and vomiting (71.2%, 67.3%, 65.4%, 59.6%, 26.9%, respectively). In spite of that, some participants had a good quality of life while others did not.
Conclusion: Patients with hepatocellular carcinoma on sorafenib treatment have variable quality of the life. The latter is significantly affected by patients’ sociodemographic characteristics and treatment-related adverse events.
- Myers, S., Neyroud-Caspar, I., Spahr, L., Gkouvatsos, K., Fournier, E., Giostra, E., Magini, G., Frossard, J.L., Bascaron, M.E., Vernaz, N. and Zampaglione, L. (2021). NAFLD and MAFLD as emerging causes of HCC: A populational study. JHEP Reports, 3(2),100231.
- Bertuccio, P., Turati, F., Carioli, G., Rodriguez, T., La Vecchia, C., Malvezzi, M. and Negri, E. (2017). Global trends and predictions in hepatocellular carcinoma mortality. Journal of hepatology, 67(2), 302-309.
- Fan, S.Y. (2011). Health-Related Quality of Life and Adjustment in Patients with Hepatocellular Carcinoma (Doctoral dissertation, University of Sheffield).
- Farazi, P.A. and DePinho, R.A. (2006). Hepatocellular carcinoma pathogenesis: from genes to environment. Nature Reviews Cancer, 6(9), 674-687.
- Cahill, B.A. and Braccia, D. (2004). Current treatment for hepatocellular carcinoma. Clinical journal of oncology nursing, 8(4), 393-400.
- Waziry, R. (2018). Clinical epidemiology of hepatocellular carcinoma among people with hepatitis B or hepatitis C infection (Doctoral dissertation, UNSW Sydney).
- Llovet, J.M., Ricci, S., Mazzaferro, V., Hilgard, P., Gane, E., Blanc, J.F., De Oliveira, A.C., Santoro, A., Raoul, J.L., Forner, A. and Schwartz, M. (2008). Sorafenib in advanced hepatocellular carcinoma. New England journal of medicine, 359(4), 378-390.
- Daher, S., Massarwa, M., Benson, A.A. and Khoury, T. )2018(. Current and future treatment of hepatocellular carcinoma: an updated comprehensive review. Journal of clinical and translational hepatology, 6(1), 69.
- Abdelgalil, A.A., Alkahtani, H.M. and Al-Jenoobi, F.I. (2019). Sorafenib. Profiles of Drug Substances, Excipients and Related Methodology, 44, 239-266.
- Blanchet, B., Billemont, B., Barete, S., Garrigue, H., Cabanes, L., Coriat, R., Francès, C., Knebelmann, B. and Goldwasser, F. (2010). Toxicity of sorafenib: clinical and molecular aspects. Expert opinion on drug safety, 9(2), 275-287.
- Heydarnejad, M.S., Hassanpour, D.A. and Solati, D.K. (2011). Factors affecting quality of life in cancer patients undergoing chemotherapy. African health sciences, 11(2), 266–270.
- Lopez, J.H., Mayordomo, A.R., Rosado, R.L., Fernandez, C.I.S. and Gallana, S. (2009). Quality of life in long-term oral cancer survivors: a comparison with Spanish general population norms. Journal of oral and maxillofacial surgery, 67(8), 1607-1614.
- Ravasco, P. (2019). Nutrition in cancer patients. Journal of clinical medicine, 8(8), 1211.
- Nagy, J. (2012). Quality of life of head and neck cancer patients after tumor treatment and subsequent maxillofacial rehabilitation (Doctoral dissertation, szte).
- Luckett, T., King, M.T., Butow, P.N., Oguchi, M., Rankin, N., Price, M.A., Hackl, N.A. and Heading, G. (2011). Choosing between the EORTC QLQ-C30 and FACT-G for measuring health-related quality of life in cancer clinical research: issues, evidence and recommendations. Annals of Oncology, 22(10), 2179-2190.
- Efficace, F., Cottone, F., Sommer, K., Kieffer, J., Aaronson, N., Fayers, P., Groenvold, M., Caocci, G., Coco, F.L., Gaidano, G. and Niscola, P. (2019). Validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 summary score in patients with hematologic malignancies. Value in Health, 22(11), 1303-1310.
- Giesinger, J. M., Loth, F. L. C., Aaronson, N. K., Arraras, J. I., Caocci, G., Efficace, F., Groenvold, M., van Leeuwen, M., Petersen, M. A., Ramage, J., Tomaszewski, K. A., Young, T., & Holzner, B. (2020). Thresholds for clinical importance were established to improve interpretation of the EORTC QLQ-C30 in clinical practice and research. Journal of Clinical Epidemiology, 118, 1-8.
- Husson, O., de Rooij, B. H., Kieffer, J., Oerlemans, S., Mols, F., Aaronson, N. K., van der Graaf, W. T. A., & van de Poll‐Franse, L. V. (2019). The EORTC QLQ‐C30 Summary Score as Prognostic Factor for Survival of Patients with Cancer in the “Real‐World”: Results from the Population‐Based PROFILES Registry. The Oncologist, 25(4), e722-e732.
- Shomura, M., Kagawa, T., Okabe, H., Shiraishi, K., Hirose, S., Arase, Y., Tsuruya, K., Takahira, S. and Mine, T., 2016. Longitudinal alterations in health-related quality of life and its impact on the clinical course of patients with advanced hepatocellular carcinoma receiving sorafenib treatment. BMC cancer, 16(1), 1-9.
- Brunocilla, P.R., Brunello, F., Carucci, P., Gaia, S., Rolle, E., Cantamessa, A., Castiglione, A., Ciccone, G. and Rizzetto, M. (2013). Sorafenib in hepatocellular carcinoma: prospective study on adverse events, quality of life, and related feasibility under daily conditions. Medical Oncology, 30(1), 1-8.
- Balogh, J., Victor III, D., Asham, E.H., Burroughs, S.G., Boktour, M., Saharia, A., Li, X., Ghobrial, R.M. and Monsour Jr, H.P. (2016). Hepatocellular carcinoma: a review. Journal of hepatocellular carcinoma, 3, 41.
- Yi, S.W., Choi, J.S., Yi, J.J., Lee, Y.H. and Han, K.J. (2018). Risk factors for hepatocellular carcinoma by age, sex, and liver disorder status: a prospective cohort study in Korea. Cancer, 124(13), 2748-2757.
- Zhou, K., Pickering, T.A., Gainey, C.S., Cockburn, M., Stern, M.C., Liu, L., Unger, J.B., El-Khoueiry, A.B. and Terrault, N.A. (2021). Presentation, management, and outcomes across the rural-urban continuum for hepatocellular carcinoma. JNCI cancer spectrum, 5(1), pkaa100.
- Galle, P.R., Finn, R.S., Qin, S., Ikeda, M., Zhu, A.X., Kim, T.Y., Kudo, M., Breder, V., Merle, P., Kaseb, A. and Li, D. (2021). Patient-reported outcomes with atezolizumab plus bevacizumab versus sorafenib in patients with unresectable hepatocellular carcinoma (IMbrave150): an open-label, randomized, phase 3 trial. The Lancet Oncology, 22(7), 991-1001.
- Baldan Ferrari, G., Coelho França Quintanilha, J., Berlofa Visacri, M., Oliveira Vaz, C., Cursino, M.A., Sampaio Amaral, L., Bastos, B., Pereira, T.T., de Oliveira, G., Paulo, J. and de Godoy Torso, N. (2020). Outcomes in hepatocellular carcinoma patients undergoing sorafenib treatment: toxicities, cellular oxidative stress, treatment adherence, and quality of life. Anti-Cancer Drugs, 31(5), 523-527.
- Vogel, A., Qin, S., Kudo, M., Su, Y., Hudgens, S., Yamashita, T., Yoon, J.H., Fartoux, L., Simon, K., López, C. and Sung, M. (2021). Lenvatinib versus sorafenib for first-line treatment of unresectable hepatocellular carcinoma: patient-reported outcomes from a randomized, open-label, non-inferiority, phase 3 trial. The Lancet Gastroenterology & Hepatology, 6(8), 649-658.
- Waldmann, A., Schubert, D. and Katalinic, A. (2013). Normative data of the EORTC QLQ-C30 for the German population: a population-based survey. PloS one, 8(9), e74149.
- Deng, Y., Zhu, J., Liu, Z., Huang, M., Chang, D.W. and Gu, J. (2020). Elevated systemic inflammatory responses, factors associated with physical and mental quality of life, and prognosis of hepatocellular carcinoma. Aging (Albany NY), 12(5), 4357.
- Burg, M.A., Adorno, G., Lopez, E.D., Loerzel, V., Stein, K., Wallace, C. and Sharma, D.K.B. (2015). Current unmet needs of cancer survivors: Analysis of open‐ended responses to the American Cancer Society Study of Cancer Survivors II. Cancer, 121(4), 623-630.
- Zhou, K. and Fountzilas, C. (2019). Outcomes and quality of life of systemic therapy in advanced hepatocellular carcinoma. Cancers, 11(6), 861.
- Brose, M.S., Frenette, C.T., Keefe, S.M. and Stein, S.M. (2014). Management of sorafenib-related adverse events: a clinician’s perspective. Seminars in Oncology, 41, S1-S16.
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