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Jacobs, D.H.M.; Horeweg, N.; Strayer, M.; Roeloffzen, E.M.A.; Speijer, G.; Merkus, J.; ... ; Koper, P.C.M. (2019)

Health-related quality of life of breast cancer patients after accelerated partial breast irradiation using intraoperative or external beam radiotherapy technique

Article / Letter to editor
Purpose: To compare health-related quality of life (HRQL) in elderly breast cancer patients between two types of Accelerated Partial Breast Irradiation: intraoperative radiotherapy (IORT) and external beam APBI (EB-APBI).Methods: Between 2011 and 2016 women >= 60 years undergoing breast conserving therapy for early stage breast cancer were included in a prospective multi-centre cohort study. Patients were treated with electron IORT (1 x 23.3 Gy) or photon EB-APBI (10 x 3.85 Gy daily). HRQL was measured by the EORTC-QLQ C30 and BR23 questionnaires before surgery and at several time points until 1 year.Results: HRQoL data was available of 204 IORT and 158 EB-APBI patients. In longitudinal analyses emotional functioning and future perspective were significantly, but not clinically relevantly, worse in IORT-treated patients, and improved significantly during follow-up in both groups. All other aspects of HRQL slightly worsened after treatment and recovered within 3 months with an...Show morePurpose: To compare health-related quality of life (HRQL) in elderly breast cancer patients between two types of Accelerated Partial Breast Irradiation: intraoperative radiotherapy (IORT) and external beam APBI (EB-APBI).Methods: Between 2011 and 2016 women >= 60 years undergoing breast conserving therapy for early stage breast cancer were included in a prospective multi-centre cohort study. Patients were treated with electron IORT (1 x 23.3 Gy) or photon EB-APBI (10 x 3.85 Gy daily). HRQL was measured by the EORTC-QLQ C30 and BR23 questionnaires before surgery and at several time points until 1 year.Results: HRQoL data was available of 204 IORT and 158 EB-APBI patients. In longitudinal analyses emotional functioning and future perspective were significantly, but not clinically relevantly, worse in IORT-treated patients, and improved significantly during follow-up in both groups. All other aspects of HRQL slightly worsened after treatment and recovered within 3 months with an improvement until 1 year. Cross-sectional analysis showed that postoperatively fatigue and role functioning were significantly worse in IORT patients compared to EB-APBI patients who were not yet irradiated, but the difference was not clinically relevant. At other timepoints there were no significant differences. Multivariable analysis at 1 year identified comorbidity and systemic therapy as risk factors for a worse global health score (GHS).Conclusions: EB-APBI and IORT were well tolerated. Despite a temporary deterioration after treatment, all HRQL scales recovered within 3 months resulting in no clinically relevant differences until 1 year between groups nor compared to baseline levels. (C) 2019 Elsevier Ltd. All rights reserved.Show less
Accelerated partial breast irradiation
Intraoperative radiotherapy
Breast cancer
Quality of life
Elderly
All authors
Jacobs, D.H.M.; Horeweg, N.; Strayer, M.; Roeloffzen, E.M.A.; Speijer, G.; Merkus, J.; Sijp, J. van der; Mast, M.E.; Fisscher, U.; Petoukhova, A.L.; Zwanenburg, A.G.; Marijnen, C.A.M.; Koper, P.C.M.
Date
2019-08-01
Journal
The Breast
Volume
46
Pages
32 - 39
DOI
doi:10.1016/j.breast.2019.04.006