Jan Haussmann1, Carolin Nestle-Kraemling2, Edwin Bölke3, Sylvia Wollandt4, Vanessa Speer1, Freddy-Joel Djiepmo Njanang1, Bálint Tamaskovics1, Peter Arne Gerber5, Klaus Orth6, Eugen Ruckhaeberle7, Tanja Fehm7, Stefanie Corradini8, Guido Lammering9, Svjetlana Mohrmann7, Werner Audretsch10, Kitti Maas1, Stephan Roth1, Kai Kammers11, Wilfried Budach1, Christiane Matuschek1. 1. Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany. 2. Heinrich Heine University, Department of Gynecologic and Obstetrics, EVK Dusseldorf, Dusseldorf, Germany. 3. Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany. boelke@med.uni-duesseldorf.de. 4. Department of Senology, Sana Kliniken Dusseldorf, Dusseldorf, Germany. 5. Department of Dermatology, Medical Faculty, Heinrich Heine University Dusseldorf, Dusseldorf, Germany. 6. Department of General, Visceral and Thoracic Surgery, Harzkliniken Goslar, Goslar, Germany. 7. Department of Gynecology, Heinrich Heine University Düsseldorf, Dusseldorf, Germany. 8. Department of Radiation Oncology, LMU University of Munich, Munich, Germany. 9. Radiotherapy Institute Bergisch Gladbach, Gladbach, Germany. 10. Department of Senology and Breast Surgery, Marienhospital Dusseldorf, Dusseldorf, Germany. 11. Division of Biostatistics and Bioinformatics, Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract
BACKGROUND: Preoperative radiotherapy (PRT) or radiochemotherapy (PRCT) is used in different tumor sites. The aim of the study was to examine the long-term quality of life (QoL) of localized / locally advanced breast cancer patients treated with PRT/PRCT followed by breast-conserving surgery (BCS) or mastectomy (ME). METHODS: Assessment of QoL was done using EORTC QLQ-C30 questionnaires for overall QoL and EORTC QLQ-BR23 for breast-specific QoL. The summary scores were categorized into 4 distinct groups to classify the results. Furthermore, a comparative analysis was performed between the study cohort and a previously published reference cohort of healthy adults. We assessed the impact of different clinical, prognostic, and treatment-related factors on selected items from C30 and BR23 using a dependence analysis. RESULTS: Out of 315 patients treated with PRT/PCRT in the years 1991 to 1999, 203 patients were alive at long-term follow-up after a mean of 17.7 years (range 14-21). 37 patients were lost to follow-up and 61 patients refused to be contacted, leading to 105 patients (64 patients after BCS and 41 after ME) being willing to undergo further clinical assessment regarding QoL outcome. Overall, QoL (QLQ-C30) was rated "excellent" or "good" in 85% (mean value) of all patients (BCS 83%, ME 88%). Comparative analysis between the study cohort and a published healthy control group revealed significantly better global health status and physical and role functioning scores in the PRT/PRCT group. The analysis demonstrates no differences in nausea/vomiting, dyspnea, insomnia, constipation, or financial difficulties. According to the dependence analysis, global QoL was associated with age, operation type and ME reconstruction. CONCLUSION: We did not detect any inferiority of PRT/PRCT compared to a healthy reference group with no hints of a detrimental long-term effect on general and breast-specific quality of life.
BACKGROUND: Preoperative radiotherapy (PRT) or radiochemotherapy (PRCT) is used in different tumor sites. The aim of the study was to examine the long-term quality of life (QoL) of localized / locally advanced breast cancerpatients treated with PRT/PRCT followed by breast-conserving surgery (BCS) or mastectomy (ME). METHODS: Assessment of QoL was done using EORTC QLQ-C30 questionnaires for overall QoL and EORTC QLQ-BR23 for breast-specific QoL. The summary scores were categorized into 4 distinct groups to classify the results. Furthermore, a comparative analysis was performed between the study cohort and a previously published reference cohort of healthy adults. We assessed the impact of different clinical, prognostic, and treatment-related factors on selected items from C30 and BR23 using a dependence analysis. RESULTS: Out of 315 patients treated with PRT/PCRT in the years 1991 to 1999, 203 patients were alive at long-term follow-up after a mean of 17.7 years (range 14-21). 37 patients were lost to follow-up and 61 patients refused to be contacted, leading to 105 patients (64 patients after BCS and 41 after ME) being willing to undergo further clinical assessment regarding QoL outcome. Overall, QoL (QLQ-C30) was rated "excellent" or "good" in 85% (mean value) of all patients (BCS 83%, ME 88%). Comparative analysis between the study cohort and a published healthy control group revealed significantly better global health status and physical and role functioning scores in the PRT/PRCT group. The analysis demonstrates no differences in nausea/vomiting, dyspnea, insomnia, constipation, or financial difficulties. According to the dependence analysis, global QoL was associated with age, operation type and ME reconstruction. CONCLUSION: We did not detect any inferiority of PRT/PRCT compared to a healthy reference group with no hints of a detrimental long-term effect on general and breast-specific quality of life.
Entities:
Keywords:
Cosmetic outcome; Evaluation; Neoadjuvant radiochemotherapy; Questionnaire; Restrospective study