Health-related quality of life after accelerated breast irradiation in five fractions: A comparison with fifteen fractions

Hulle, Hans Van; Vakaet, Vincent; Bultijnck, Renée; Deseyne, Pieter; Schoepen, Max; Greveling, Annick Van; Post, Giselle; Neve, Wilfried De; Monten, Christel; Lievens, Yolande; Veldeman, Liv

doi:10.1016/j.radonc.2020.07.007

Cited by 16 publications

(11 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Matched-case analyses with patients treated in 15 fractions showed less acute [12] and less late [13] toxicity for 5 fractions except for fibrosis outside the tumour bed. Better health-related quality of life (HRQoL) was observed in the group treated in 5 fractions, both immediately after RT and after 1 year [14].…”

Section: Introductionmentioning

confidence: 99%

Acute toxicity and health-related quality of life after accelerated whole breast irradiation in 5 fractions with simultaneous integrated boost

et al. 2021

Self Cite

View full text Add to dashboard Cite

Introduction: Acceleration of radiotherapy in 5 fractions for breast cancer can reduce the burden of treatment. We report on acute toxicity after whole-breast irradiation with a simultaneous integrated boost in 5 fractions over 10e12 days. Material and methods: Acute toxicity and health-related quality of life (HRQoL) of 200 patients, randomized between a 15-or 5-fractions schedule, were collected, using the CTCAE toxicity scoring system, the Multidimensional Fatigue Inventory, EORTC QLQ-C30 and BR23 and the BREAST-Q questionnaire. The prescribed dose to the breast was either 15*2.67 Gy (40.05 Gy) or 5*5.7 Gy (28.5 Gy). 90% of patients received a SIB to a cumulative dose of 46.8 Gy (15*3.12 Gy) or 31 Gy (5*6.2 Gy). Results: Physician-assessed toxicity was lower for the 5-fractions group. A significant difference was observed for breast pain (p ¼ 0.002), fatigue (p < 0.0001), breast edema (p ¼ 0.001) and dermatitis (p ¼ 0.003). Patients treated in 5 fractions reported better mean HRQoL scores for breast symptoms (p ¼ 0.001) and physical well-being (p ¼ 0.001). A clinically important deterioration in HRQoL of 10 points or more was also less frequently observed in the latter group for physical functioning (p ¼ 0.0005), social functioning (p ¼ 0.0007), fatigue (p ¼ 0.003), breast symptoms (p ¼ 0.0002) and physical wellbeing (p ¼ 0.002). Conclusion:In this single institute study, acute toxicity of accelerated breast radiotherapy in 5 fractions over 10e12 days seems to compare favourably to hypofractionated breast radiotherapy in 15 fractions. Less breast edema, dermatitis, desquamation, breast pain and fatigue are seen. Social and physical functioning are also less disturbed and patients have a better future perspective.

show abstract

Section: Introductionmentioning

confidence: 99%

Acute toxicity and health-related quality of life after accelerated whole breast irradiation in 5 fractions with simultaneous integrated boost

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…For the 5-fractions schedule over 10–12 days no long-term randomized evidence exists. An interim analysis of the YO-HAI5 study, randomizing between 5 fractions over 10–12 days and 15 fractions over 3 weeks, showed less acute toxicity [ 12 ] and better short-term HRQoL for the 5 fractions schedule [ 14 ]. A matched-case analysis with patients treated in 15 fractions, showed less 2-year toxicity except for fibrosis outside of the tumour bed [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…Accelerated RT in 5 fractions did not increase the risk of local relapse at 10 and 5-years in the recently published FAST and FAST-FORWARD trials, respectively [ 10 , 11 ]. Moreover, acceleration in 5 fractions resulted in lower acute toxicity with similar late toxicity, better health related quality of life (HRQoL), and OTT [ 10 , [12] , [13] , [14] ]. The European Society of Medical Oncology (ESMO) guidelines recommend a radiotherapy boost to the tumorbed in patients with a high risk of recurrence [ 1 ], as is often the case in patients receiving NACT.…”

Section: Introductionmentioning

confidence: 99%

Safety of pre- or postoperative accelerated radiotherapy in 5 fractions: A randomized pilot trial

Vakaet¹,

Hulle²,

Koen³

et al. 2022

The Breast

Self Cite

View full text Add to dashboard Cite

Objective Neo-adjuvant radiotherapy (NART) for breast cancer has shown promising survival results in retrospective trials. However, there are some obstacles such as a chemotherapy delay, an increased overall treatment time (OTT) and the risk of increasing surgical morbidity. Accelerated radiotherapy (RT) in 5 fractions allows to deliver NART in a very short time span and minimizes the delay of surgery and chemotherapy. This trial investigates this NART schedule for safety, feasibility and OTT. Material and methods Twenty patients eligible for neo-adjuvant chemotherapy (NACT) and breast conserving surgery, were randomized between NART before NACT or NACT and postoperative RT. In both arms, RT treatment was given in 5 fractions to the whole breast with a simultaneously integrated boost (SIB) on the tumor(bed). Lymph node irradiation was given concomitantly in case of lymph node involvement. OTT was defined as the time from diagnosis to last surgery in the intervention group, while in the control group the time between diagnosis and last RT-fraction was used. In the intervention group NACT-delay was defined as time between diagnosis and start of chemotherapy. Results 20 patients were included, and 19 patients completed treatment. OTT was significantly shorter in the intervention group (mean 218 days, range 196–253) compared to the control group (mean 237, range 211–268, p = 0.001). The difference in mean duration from diagnosis to the first treatment was a non-significant 4 days longer (31 vs 27 days, p = 0.28), but the start of NACT after diagnosis was delayed by 21 days (48 vs 27 days, p < 0.001). NART did not result in additional surgery complications. Conclusion This pilot trial is the first to report on accelerated NART in 5 fractions with SIB. NART before NACT resulted in a shorter OTT with good safety results.

show abstract

“…Shorter treatment duration can also reduce impact on short term HRQL as it might shorten the time it takes a patient to recover from the intensive period of treatment. Several studies have shown quick recovery in patients treated with accelerated compared to conventional radiotherapy [ 12 , 14 , 30 ]. From our data it seems that patients treated with APBI recover faster, within 3 months after treatment, than patients treated with hypo-WBI, possibly explained by a shortened treatment time.…”

Section: Discussionmentioning

confidence: 99%

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

Jacobs

Charaghvandi

Horeweg

et al. 2021

Breast Cancer Res Treat

View full text Add to dashboard Cite

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.

show abstract

Health-related quality of life after accelerated breast irradiation in five fractions: A comparison with fifteen fractions

Cited by 16 publications

References 38 publications

Acute toxicity and health-related quality of life after accelerated whole breast irradiation in 5 fractions with simultaneous integrated boost

Acute toxicity and health-related quality of life after accelerated whole breast irradiation in 5 fractions with simultaneous integrated boost

Safety of pre- or postoperative accelerated radiotherapy in 5 fractions: A randomized pilot trial

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

Contact Info

Product

Resources

About