PURPOSE: To compare the quality-adjusted life expectancy between women treated with partial breast irradiation (PBI) vs. whole breast radiotherapy (WBRT) for estrogen receptor-positive early-stage breast cancer. METHODS AND MATERIALS: We developed a Markov model to describe health states in the 15 years after radiotherapy for estrogen receptor-positive early-stage breast cancer. Breast cancer recurrences were separated into local recurrences and elsewhere failures. Ipsilateral breast tumor recurrence (IBTR) risk was extracted from the Oxford overview, and rates and utilities were adapted from the literature. We studied two cohorts of women (aged 40 and 55 years), both of whom received adjuvant tamoxifen. RESULTS: Assuming a no evidence of disease (NED)-PBI utility of 0.93, quality-adjusted life expectancy after PBI (and WBRT) was 12.61 (12.57) and 12.10 (12.06) years for 40-year-old and 55-year-old women, respectively. The NED-PBI utility thresholds for preferring PBI over WBRT were 0.923 and 0.921 for 40-year-old and 55-year-old women, respectively, both slightly greater than the NED-WBRT utility. Outcomes were sensitive to the utility of NED-PBI, the PBI hazard ratio for local recurrence, the baseline IBTR risk, and the percentage of IBTRs that were local. Overall the degree of superiority of PBI over WBRT was greater for 55-year-old women than for 40-year-old women. CONCLUSIONS: For most utility values of the NED-PBI health state, PBI was the preferred treatment modality. This result was highly sensitive to patient preferences and was also dependent on patient age, PBI efficacy, IBTR risk, and the fraction of IBTRs that were local.
PURPOSE: To compare the quality-adjusted life expectancy between women treated with partial breast irradiation (PBI) vs. whole breast radiotherapy (WBRT) for estrogen receptor-positive early-stage breast cancer. METHODS AND MATERIALS: We developed a Markov model to describe health states in the 15 years after radiotherapy for estrogen receptor-positive early-stage breast cancer. Breast cancer recurrences were separated into local recurrences and elsewhere failures. Ipsilateral breast tumor recurrence (IBTR) risk was extracted from the Oxford overview, and rates and utilities were adapted from the literature. We studied two cohorts of women (aged 40 and 55 years), both of whom received adjuvant tamoxifen. RESULTS: Assuming a no evidence of disease (NED)-PBI utility of 0.93, quality-adjusted life expectancy after PBI (and WBRT) was 12.61 (12.57) and 12.10 (12.06) years for 40-year-old and 55-year-old women, respectively. The NED-PBI utility thresholds for preferring PBI over WBRT were 0.923 and 0.921 for 40-year-old and 55-year-old women, respectively, both slightly greater than the NED-WBRT utility. Outcomes were sensitive to the utility of NED-PBI, the PBI hazard ratio for local recurrence, the baseline IBTR risk, and the percentage of IBTRs that were local. Overall the degree of superiority of PBI over WBRT was greater for 55-year-old women than for 40-year-old women. CONCLUSIONS: For most utility values of the NED-PBI health state, PBI was the preferred treatment modality. This result was highly sensitive to patient preferences and was also dependent on patient age, PBI efficacy, IBTR risk, and the fraction of IBTRs that were local.
Authors: H Bartelink; J C Horiot; P Poortmans; H Struikmans; W Van den Bogaert; I Barillot; A Fourquet; J Borger; J Jager; W Hoogenraad; L Collette; M Pierart Journal: N Engl J Med Date: 2001-11-08 Impact factor: 91.245
Authors: A C Voogd; M Nielsen; J L Peterse; M Blichert-Toft; H Bartelink; M Overgaard; G van Tienhoven; K W Andersen; R J Sylvester; J A van Dongen Journal: J Clin Oncol Date: 2001-03-15 Impact factor: 44.544
Authors: U Veronesi; E Marubini; L Mariani; V Galimberti; A Luini; P Veronesi; B Salvadori; R Zucali Journal: Ann Oncol Date: 2001-07 Impact factor: 32.976
Authors: Arpana M Naik; Jane Fey; Mary Gemignani; Alexandra Heerdt; Leslie Montgomery; Jeanne Petrek; Elisa Port; Virgilio Sacchini; Lisa Sclafani; Kimberly VanZee; Raquel Wagman; Patrick I Borgen; Hiram S Cody Journal: Ann Surg Date: 2004-09 Impact factor: 12.969
Authors: J Sanz; N Rodríguez; P Foro; J Dengra; A Reig; P Pérez; I Membrive; A Ortiz; M Codinach; M Algara Journal: Clin Transl Oncol Date: 2016-09-21 Impact factor: 3.405
Authors: David J Sher; Eve Wittenberg; W Warren Suh; Alphonse G Taghian; Rinaa S Punglia Journal: Int J Radiat Oncol Biol Phys Date: 2008-10-27 Impact factor: 7.038