Quality of life after melphalan percutaneous hepatic perfusion for patients with metastatic uveal melanoma
Quality of life after melphalan percutaneous hepatic perfusion for patients with metastatic uveal melanoma
Background: recent studies indicate that melphalan percutaneous hepatic perfusion (M-PHP) for liver metastases from ocular melanoma (mUM) improves survival. Importantly, this benefit must be carefully balanced with changes in a patient's quality of life (QoL). This study examines the QoL changes post-M-PHP.
Methods: retrospective analysis of the change in QoL using the Functional Assessment of Cancer Therapy-General (FACT-G) with mUM patients receiving M-PHP ( n = 20). The FACT-G scores, which comprise physical (PWB), social (SWB), emotional (EWB) and functional (FWB) wellbeing were measured pre-procedure and at day 1, day of discharge (mean = 2.4 days), 7, 14 and 28 days after M-PHP therapy. Wilcoxon signed-rank test gauged QoL domain changes.
Results: baseline FACT-G median (IQR) scores were 101.8 (21.8). QoL scoring significantly decreased immediately after the procedure [day 1; 85 (27.5); P = 0.002] and gradually improved over time. By day 28, QoL almost returned to pre-procedure levels [100.3 (13.8); P = 0.31]. Subscore analysis revealed that the initial drop in QoL at day 1 post-procedure was attributable to the PWB (28 vs. 24; P = 0.001) and FWB domains (26 vs. 18.5; P < 0.001). By day 28 there was a statistically significant improvement in EWB ( P = 0.01).
Conclusion: QoL following M-PHP decreases immediately after therapy and is not significantly different from baseline by the day of discharge. By day 28 there is improved emotional well-being. This study could help to optimize the time between treatment cycles when combined with toxicity data and blood count recovery.
Vigneswaran, Ganesh
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Malalasekera, Weeratunge
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Smith, Victoria
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Gibson, Tom
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Patel, Shian
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Wheater, Matthew
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Karydis, Ioannis
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Gupta, Sanjay
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Stedman, Brian
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Modi, Sachin
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Vigneswaran, Ganesh
4e3865ad-1a15-4a27-b810-55348e7baceb
Malalasekera, Weeratunge
a3a8849c-75ba-4ada-b5b5-acce0f4f73c6
Smith, Victoria
64d81cf5-2460-4a05-a05f-359fca6d31c7
Gibson, Tom
b0d53572-14bd-4614-8ddd-6d69135a90bf
Patel, Shian
f91303ab-8aef-42b3-a5c9-5e6d4fbdfaef
Wheater, Matthew
3691c3d8-8589-4693-a0dc-c6a8648cd7df
Karydis, Ioannis
95a2388c-7165-40e1-8b73-87234caea36d
Gupta, Sanjay
3eae7ae7-8915-4c1f-8f28-2882160b9a62
Stedman, Brian
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Modi, Sachin
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Vigneswaran, Ganesh, Malalasekera, Weeratunge, Smith, Victoria, Gibson, Tom, Patel, Shian, Wheater, Matthew, Karydis, Ioannis, Gupta, Sanjay, Stedman, Brian and Modi, Sachin
(2023)
Quality of life after melphalan percutaneous hepatic perfusion for patients with metastatic uveal melanoma.
Melanoma Research.
(doi:10.1097/CMR.0000000000000947).
Abstract
Background: recent studies indicate that melphalan percutaneous hepatic perfusion (M-PHP) for liver metastases from ocular melanoma (mUM) improves survival. Importantly, this benefit must be carefully balanced with changes in a patient's quality of life (QoL). This study examines the QoL changes post-M-PHP.
Methods: retrospective analysis of the change in QoL using the Functional Assessment of Cancer Therapy-General (FACT-G) with mUM patients receiving M-PHP ( n = 20). The FACT-G scores, which comprise physical (PWB), social (SWB), emotional (EWB) and functional (FWB) wellbeing were measured pre-procedure and at day 1, day of discharge (mean = 2.4 days), 7, 14 and 28 days after M-PHP therapy. Wilcoxon signed-rank test gauged QoL domain changes.
Results: baseline FACT-G median (IQR) scores were 101.8 (21.8). QoL scoring significantly decreased immediately after the procedure [day 1; 85 (27.5); P = 0.002] and gradually improved over time. By day 28, QoL almost returned to pre-procedure levels [100.3 (13.8); P = 0.31]. Subscore analysis revealed that the initial drop in QoL at day 1 post-procedure was attributable to the PWB (28 vs. 24; P = 0.001) and FWB domains (26 vs. 18.5; P < 0.001). By day 28 there was a statistically significant improvement in EWB ( P = 0.01).
Conclusion: QoL following M-PHP decreases immediately after therapy and is not significantly different from baseline by the day of discharge. By day 28 there is improved emotional well-being. This study could help to optimize the time between treatment cycles when combined with toxicity data and blood count recovery.
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e-pub ahead of print date: 1 December 2023
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Local EPrints ID: 486892
URI: http://eprints.soton.ac.uk/id/eprint/486892
ISSN: 0960-8931
PURE UUID: 769f7f5d-7c56-4bb5-ad67-5aa97312864c
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Date deposited: 08 Feb 2024 17:35
Last modified: 18 Mar 2024 04:01
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Author:
Weeratunge Malalasekera
Author:
Victoria Smith
Author:
Tom Gibson
Author:
Shian Patel
Author:
Matthew Wheater
Author:
Ioannis Karydis
Author:
Sanjay Gupta
Author:
Brian Stedman
Author:
Sachin Modi
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