Long-term quality of life after preoperative radiochemotherapy in patients with localized and locally advanced breast cancer

Haussmann, Jan; Nestle-Kraemling, Carolin; Bölke, Edwin; Wollandt, Sylvia; Speer, Vanessa; Njanang, Freddy Joel Djiepmo; Tamaskovics, Bálint; Gerber, Peter Arne; Orth, Klaus; Ruckhaeberle, Eugen; Fehm, Tanja; Corradini, Stefanie; Lammering, Guido; Mohrmann, Svjetlana; Audretsch, Werner; Maas, Kitti; Roth, Stephan; Kammers, Kai; Budach, Wilfried; Matuschek, Christiane

doi:10.1007/s00066-019-01557-z

Cited by 10 publications

(9 citation statements)

References 39 publications

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“…Radiotherapy of the breast is an obligatory part of a breast-conserving treatment concept and can lead to a significant improvement in locoregional control, breast cancer-specific survival, and, in long-term follow-up, also in overall survival [ 7 ]. Despite the always better and increasingly gentle techniques [ 8 ], breast cancer radiotherapy influences aspects of quality of life such as physical well-being [ 9 , 10 ]. Furthermore, despite the very positive influence on the prognosis or cure, radiotherapy of the breast may lead to a substantial increase of anxiety and depression.…”

Section: Introductionmentioning

confidence: 99%

Anxiety and depression in patients with breast cancer undergoing radiotherapy: the role of intelligence, life history, and social support—preliminary results from a monocentric analysis

et al. 2022

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Purpose It is known that the diagnosis of breast cancer often causes anxiety and depression. Radiotherapy of the breast as an obligatory part of a breast-conserving treatment concept can markedly increase these psychological symptoms in many, but not all patients. In this clinical observational study, we aimed at identifying cognitive, health-related and social factors that may either enhance or reduce the emergence of anxiety and depression. Methods Using a longitudinal study design with 25 women (mean age: 52.9 years; SD = 10.6; age range 29–70 years) with a first diagnosis of nonmetastatic breast cancer, measures of anxiety, depression, situational emotional states, intelligence, and aspects of social frameworks were assessed before, during, and after radiotherapy of the breast. At 4 time-points, standard and self-constructed questionnaires were used to assess the course of anxiety and depressive symptoms across the radiotherapy intervention. Results We found that anxiety is highest immediately before the start of radiation therapy, while the anxiety level was lowest on the day that therapy was completed. Anxiety and depression were enhanced in women with a lifetime history of chronic diseases at all time points of measurement. Moreover, women with high intelligence and low social support had stronger symptoms of depression than women with low intelligence and a stable family background at some time points of measurement. The degree of anxiety was neither related to intelligence nor to social support. Conclusion For the first time, we demonstrate empirical pilot data on cognitive and social modulators of anxiety and depression in women with breast cancer over the course of radiotherapy. Our results may help to optimize clinical procedures and thereby reduce symptoms of anxiety and depression in these patients.

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Section: Introductionmentioning

confidence: 99%

Anxiety and depression in patients with breast cancer undergoing radiotherapy: the role of intelligence, life history, and social support—preliminary results from a monocentric analysis

et al. 2022

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“…The results of this cohort including patients with high-risk breast cancer treated with naCT and naRT followed by breast-conserving surgery or mastectomy showed acceptable survival rates, with 53.1% being alive after a 20-year follow-up. Long-term adverse events were also reported to be rare and cosmetic outcomes and quality of life assessments were favorable [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors of Long-Term Survival after Neoadjuvant Radiotherapy and Chemotherapy in High-Risk Breast Cancer

Haussmann

Budach

Nestle-Krämling

et al. 2022

Cancers

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Background: Neoadjuvant radiotherapy (naRT) in addition to neoadjuvant chemotherapy (naCT) has been used for locally advanced, inoperable breast cancer or to allow breast conserving surgery (BCS). Retrospective analyses suggest that naRT + naCT might result in an improvement in pathological complete response (pCR rate and disease-free survival). pCR is a surrogate parameter for improved event-free and overall survival (OS) and allows for the adaption of the post-neoadjuvant therapy regimens. However, it is not clear whether pCR achieved with the addition of naRT has the same prognostic value. Patients and methods: We performed a retrospective re-analysis of 356 patients (cT1-cT4/cN0-N+) treated with naRT and naCT with a long-term follow-up. Patients underwent naRT on the breast and regional lymph nodes combined with a boost to the primary tumor. Chemotherapy with different agents was given either sequentially or concomitantly to naRT. We used the Cox proportional hazard regression model to estimate the effect of pCR in our cohort in different subgroups as well as chemotherapy protocols. Clinical response markers correlating with OS were also analyzed. Results: For patients with median follow-ups of 20 years, 10 years, 15 years, 20 years, and 25 years, OS rates were 69.7%, 60.6%, 53.1%, and 45.1%, respectively. pCR was achieved in 31.1% of patients and associated with a significant improvement in OS (HR = 0.58; CI-95%: 0.41–0.80; p = 0.001). The prognostic impact of pCR was evident across breast cancer subtypes and chemotherapy regimens. Multivariate analysis showed that age, clinical tumor and nodal stage, chemotherapy, and pCR were prognostic for OS. Conclusion: NaCT and naRT prior to surgical resection achieve good long-term survival in high-risk breast cancer. pCR after naRT maintains its prognostic value in breast cancer subtypes and across different subgroups. pCR driven by naRT and naCT independently influences long-term survival.

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“…Breast cancer treatment involves a multimodal approach that includes chemotherapy [15]. Chemotherapy can significantly improve survival and quality of life compared to best supportive care in patients with breast cancer [16][17][18]. However, adverse effects of chemotherapy in patients with malignant tumors include fatigue, nausea and vomiting, bone marrow suppression, renal toxicity, neurotoxicity and cancer-related cognitive impairment [19].…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of spleen aminopeptide oral lyophilized powder for improving quality of life and immune response in patients with advanced breast cancer: a multicenter, randomized, double-blind, placebo-controlled clinical trial

Wang

Ma²,

Shang³

et al. 2021

Anti-Cancer Drugs

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Health-related quality of life (HRQoL) is an important consideration in managing patients. Spleen aminopeptide oral lyophilized powder (SAOLP) has been used to enhance cellular immunity in a patient. This multicenter, randomized, double-blind, placebo-controlled clinical trial was designed to evaluate the safety and efficacy of SAOLP for improving HRQoL in patients with breast cancer. Patients diagnosed with advanced breast cancer were included, and were administered SAOLP or placebo 4 mg qd for two cycles. The primary endpoint was improvement in HRQoL on day 42 measured by the EORTC QLQ-C30 and EORTC QLQ-BR23. Secondary endpoints included immunologic function, improvement in HRQoL on day 21 and 84, objective response rate, disease control rate, BMI and adverse events. On day 42, on the EORTC QLQ-C30 or EORTC QLQ-BR23, scores on the functional scales and QoL scale were significantly higher and scores on symptom scales were significantly lower in patients who received SAOLP compared to placebo ( P < 0.05). On day 84, the number of CD3, CD4 and CD8 cells were significantly higher in patients who received SAOLP. There were no significant differences in objective response rate, disease control rate or BMI. SAOLP may improve HRQoL and the immune response in patients with advanced breast cancer, represents a convenient and safe adjuvant therapy.

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Long-term quality of life after preoperative radiochemotherapy in patients with localized and locally advanced breast cancer

Cited by 10 publications

References 39 publications

Anxiety and depression in patients with breast cancer undergoing radiotherapy: the role of intelligence, life history, and social support—preliminary results from a monocentric analysis

Anxiety and depression in patients with breast cancer undergoing radiotherapy: the role of intelligence, life history, and social support—preliminary results from a monocentric analysis

Predictive Factors of Long-Term Survival after Neoadjuvant Radiotherapy and Chemotherapy in High-Risk Breast Cancer

Safety and efficacy of spleen aminopeptide oral lyophilized powder for improving quality of life and immune response in patients with advanced breast cancer: a multicenter, randomized, double-blind, placebo-controlled clinical trial

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