Prospective evaluation of the quality of life and safety in patients receiving hepatic artery infusion pump chemotherapy

Abstract

Background and objectives

Hepatic Artery Infusion (HAI) Pump placement and subsequent 6 + months of HAI chemotherapy is an intensive treatment regimen available to select patients with colorectal liver metastasis. The effects on quality of life (QOL) from HAI placement and chemotherapy are largely unknown. We aimed to evaluate the use of patient-reported outcome (PRO) surveys to measure the QOL in these patients.

Methods

Patients scheduled for HAI pump placement between 2022 and 2023 were prospectively enrolled. PROs were collected using PROMIS and LASA scales preoperatively, postoperative (POD) days 2, 7, 14, and monthly until 6 months. Complications were recorded using Clavien-Dindo score.

Results

Twelve patients were included. Median [IQR] age at surgery was 55.0 (43.8–62.5) years. All patients successfully initiated HAI and systemic therapy. Mean (± SD) LASA QOL was 8.0 ± 1.9 preoperatively, 6.4 ± 1.8 on POD 2, 7.2 ± 1.3 at 1 month, 8.2 ± 1.3 at 3 months, and 7.5 ± 1.7 at 6 months. LASA QOL, pain severity, and fatigue scores returned to baseline in 8/11, 10/11, and 8/11 patients at 3 months, respectively. At 6 months, 3/11, 9/11, and 7/11 patients reported return to baseline social, pain, and fatigue scores.

Conclusions

PROMIS and LASA measures are potential tools for evaluating PROs in patient undergoing HAI therapy. Preliminary data suggests baseline QOL mostly returns within 3 months of HAI placement, and initiation of HAI treatment does not appear to significantly impact QOL. These results support the inclusion of such PROs in future randomized trials to assess effects of HAI chemotherapy on QOL.