Daphne H M Jacobs1,2, Ramona K Charaghvandi3,4, Nanda Horeweg5, John H Maduro6, Gabrielle Speijer7, Ellen M A Roeloffzen8, Mirjam Mast9, Enja Bantema-Joppe10, Anna L Petoukhova9, Desirée H J G van den Bongard11, Peter Koper9, Anne P G Crijns6, Corrie A M Marijnen12, Helena M Verkooijen3. 1. Department of Radiation Oncology, Leiden University Medical Center, Albinusdreef 2, PO box 9600, 2300 RC, Leiden, The Netherlands. d.h.m.jacobs@lumc.nl. 2. Department of Radiation Oncology, Haaglanden Medical Center, Burgemeester Banninglaan, 2262 BA, Leidschendam, The Netherlands. d.h.m.jacobs@lumc.nl. 3. Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands. 4. Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands. 5. Department of Radiation Oncology, Leiden University Medical Center, Albinusdreef 2, PO box 9600, 2300 RC, Leiden, The Netherlands. 6. Department of Radiation Oncology, University Medical Center, Groningen, Groningen, The Netherlands. 7. Department of Radiation Oncology, Haga Hospital, The Hague, The Netherlands. 8. Department of Radiation Oncology, Isala Clinics, Zwolle, The Netherlands. 9. Department of Radiation Oncology, Haaglanden Medical Center, Burgemeester Banninglaan, 2262 BA, Leidschendam, The Netherlands. 10. Department of Radiation Oncology, Radiotherapy Institute Friesland, Friesland, The Netherlands. 11. Department of Radiation Oncology, Amsterdam University Medical Centers, Amsterdam, The Netherlands. 12. Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Abstract
PURPOSE: To evaluate and compare health-related quality of life (HRQL) of women with early-stage breast cancer (BC) treated with different radiotherapy (RT) regimens. METHODS: Data were collected from five prospective cohorts of BC patients treated with breast-conserving surgery and different RT regimens: intraoperative RT (IORT, 1 × 23.3 Gy; n = 267), external beam accelerated partial breast irradiation (EB-APBI, 10 × 3.85 Gy; n = 206), hypofractionated whole breast irradiation(hypo-WBI, 16 × 2.67 Gy; n = 375), hypo-WBI + boost(hypo-WBI-B, 21-26 × 2.67 Gy; n = 189), and simultaneous WBI + boost(WBI-B, 28 × 2.3 Gy; n = 475). Women ≥ 60 years with invasive/in situ carcinoma ≤ 30 mm, cN0 and pN0-1a were included. Validated EORTC QLQ-C30/BR23 questionnaires were used to asses HRQL. Multivariable linear regression models adjusted for confounding (age, comorbidity, pT, locoregional treatment, systemic therapy) were used to compare the impact of the RT regimens on HRQL at 12 and 24 months. Differences in HRQL over time (3-24 months) were evaluated using linear mixed models. RESULTS: There were no significant differences in HRQL at 12 months between groups except for breast symptoms which were better after IORT and EB-APBI compared to hypo-WBI at 12 months (p < 0.001). Over time, breast symptoms, fatigue, global health status and role functioning were significantly better after IORT and EB-APBI than hypo-WBI. At 24 months, HRQL was comparable in all groups. CONCLUSION: In women with early-stage breast cancer, the radiotherapy regimen did not substantially influence long-term HRQL with the exception of breast symptoms. Breast symptoms are more common after WBI than after IORT or EB-APBI and improve slowly until no significant difference remains at 2 years posttreatment.
PURPOSE: To evaluate and compare health-related quality of life (HRQL) of women with early-stage breast cancer (BC) treated with different radiotherapy (RT) regimens. METHODS: Data were collected from five prospective cohorts of BC patients treated with breast-conserving surgery and different RT regimens: intraoperative RT (IORT, 1 × 23.3 Gy; n = 267), external beam accelerated partial breast irradiation (EB-APBI, 10 × 3.85 Gy; n = 206), hypofractionated whole breast irradiation(hypo-WBI, 16 × 2.67 Gy; n = 375), hypo-WBI + boost(hypo-WBI-B, 21-26 × 2.67 Gy; n = 189), and simultaneous WBI + boost(WBI-B, 28 × 2.3 Gy; n = 475). Women ≥ 60 years with invasive/in situ carcinoma ≤ 30 mm, cN0 and pN0-1a were included. Validated EORTC QLQ-C30/BR23 questionnaires were used to asses HRQL. Multivariable linear regression models adjusted for confounding (age, comorbidity, pT, locoregional treatment, systemic therapy) were used to compare the impact of the RT regimens on HRQL at 12 and 24 months. Differences in HRQL over time (3-24 months) were evaluated using linear mixed models. RESULTS: There were no significant differences in HRQL at 12 months between groups except for breast symptoms which were better after IORT and EB-APBI compared to hypo-WBI at 12 months (p < 0.001). Over time, breast symptoms, fatigue, global health status and role functioning were significantly better after IORT and EB-APBI than hypo-WBI. At 24 months, HRQL was comparable in all groups. CONCLUSION: In women with early-stage breast cancer, the radiotherapy regimen did not substantially influence long-term HRQL with the exception of breast symptoms. Breast symptoms are more common after WBI than after IORT or EB-APBI and improve slowly until no significant difference remains at 2 years posttreatment.
Entities:
Keywords:
Accelerated Partial Breast Irradiation; Early-stage breast cancer; Health-related quality of life; Intraoperative radiotherapy
Authors: François Gernier; Florence Joly; Delphine Klein; Mariette Mercier; Michel Velten; Idlir Licaj Journal: Support Care Cancer Date: 2020-04-06 Impact factor: 3.603