Health-related quality of life of early-stage breast cancer patients after different radiotherapy regimens

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.

Treatment Outcomes and Its Associated Factors Among Adult Patients with Selected Solid Malignancies at Kenyatta National Hospital: A Hospital-Based Prospective Cohort Study

“…45 Contrastingly, radiotherapy treatment did not substantially improve the health-related quality of life in early-stage breast cancer patients. 46 However, endocrine therapy with aromatase enzyme inhibitors had a significant positive association with most health-related quality of life domains. 47 Previous systematic reviews reported that breast cancer patients with metastatic disease had a worse health-related quality of life.…”

Intraoperative radiation therapy in the treatment of breast cancer. From the past to the future

“…Работа проведена для того, чтобы выявить преимущества протокола TARGIT, по сравнению с ДЛТ у больных РМЖ на ранних стадиях. Общее количество пациентов составило 2298, в группе ИОЛТ пятилетний риск локального рецидивирования составлял 2,1%, а в группе ДЛТ -1,1%, что не имеет статистически значимых различий [32].…”

(Pre)treatment risk factors for late fatigue and fatigue trajectories following radiotherapy for breast cancer

“…Most observational studies evaluating fatigue in breast cancer patients have been cross‐sectional studies that focused on acute fatigue, with assessments up to 6 months after treatment completion. Only a small proportion evaluated CRF beyond 6 months and, from those, even fewer focused on RT‐treated patients 8‐11 . More than 20 different instruments have been employed to evaluate CRF, contributing to a large heterogeneity in its measurement 12 .…”