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

Jacobs, D.; Horeweg, Nanda; Straver, Marieke E.; Roeloffzen, Ellen M.A.; Speijer, G.; Merkus, J. W. S.; Sijp, Joost van der; Mast, M.; Fisscher, U.; Petoukhova, A.; Zwanenburg, A.G.; Marijnen, Corrie A.M.; Koper, P.

doi:10.1016/j.breast.2019.04.006

Cited by 14 publications

(11 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Eligible patients were selected from the following Dutch prospective cohorts. From 2011 to 2016, patients were treated with intraoperative electron radiotherapy to the tumour bed(IORT cohort, 6–12 MeV, 1 fraction of 23.3 Gy to the surgical bed during surgery; n = 267) at the Haaglanden Medical Centre in a cohort study(10–042 METC ZuidwestHolland; NTR2931) [ 14 , 15 ]. In another study cohort patients received photon external beam accelerated partial breast irradiation (EB-APBI cohort, ten daily fractions of 3.87 Gy; n = 206) at the Haga Hospital and Isala clinics.…”

Section: Methodsmentioning

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

Section: Methodsmentioning

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

show abstract

“…The patients with partial breast RT showed lower rates of fatigue; women who received whole breast RT reported worsened fatigue over time [9]. In another study with 362 older women undergoing breast-conserving therapy for early-stage BC, two types of accelerated partial breast irradiation were compared: intraoperative electron RT and EB-APBI with 10 × 3.85 Gy [51]. The cross-sectional analysis showed significantly worse fatigue symptoms in intraoperative electron RT patients than in EB-APBI patients, which normalized after 3 months.…”

Section: Impact Of Irradiationmentioning

confidence: 99%

Radiotherapy-Induced Fatigue in Breast Cancer Patients

et al. 2020

View full text Add to dashboard Cite

Background: A large proportionof breast cancer patients who undergo adjuvant radiotherapy suffer from radiotherapy-induced fatigue. The possible causative factors of this specific side effect are diverse. Summary: Prevalence, duration, and severity of radiotherapy-induced fatigue are dependent on the type of radiotherapy, as well as on the irradiated volume, dose scheme, on the number of radiation fields, the combination with other treatments, diurnal rhythm, smoking, and time-to-hospitalization. Recommended treatments include non-pharmacologic interventions, such as physical and psychosocial interventions. Pharmacologic therapies include treatment with methylphenidate and modafinil. In addition to its early detection with standardized instruments, adequate education to breast cancer patients about risks and predisposing factors of radiotherapy-induced fatigue is essential. Multidimensional strategies help to maintain the patients’ quality of life and therefore guarantee treatment adherence and efficacy. Key Messages: Radiotherapy-induced fatigue is an underreported, underdiagnosed, and undertreated side effect. This review provides an overview of radiotherapy-induced fatigue in breast cancer patients receiving adjuvant radiotherapy.

show abstract

“…It also has better cosmetic outcomes and prevents delays, thus reducing residual tumor cell repair and proliferation. Jacobs et al [7] reported that IORT had better outcomes than external beam APBI (EB-APBI) when he compared the health-related quality (HRQL) of life during the rst year after treatment.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Intraoperative Radiotherapy for Early-Stage Breast Cancer in China: A Multicenter Real-World Study

et al. 2021

View full text Add to dashboard Cite

Background: To assess the e cacy, safety, and cosmetic effects of breast-conserving surgery (BCS) combined with intraoperative radiotherapy (IORT) in Chinese people. Methods: A retrospective analysis was performed on 451 patients who received IORT at four hospitals in China. IORT was delivered directly to the mammary gland before and after surgery. The primary endpoint was ipsilateral breast tumor recurrence (IBTR). The secondary endpoints were locoregional recurrence (LRR), overall survival (OS), disease-free survival (DFS), IORT-related toxicities, and cosmetic outcomes.Results: The median follow-up was 5.4 years (with a range of 1.0 to 11.9 years). The overall IBTR was 1.5%, LRR was 2.8%, and the OS rate and DFS rate were 96.2% and 99.1%, respectively. Only one (0.2%) breast cancer-related death was recorded. The cancer-related distant metastasis rate was 0.6%. There was no intraoperative or postoperative radiation-related acute hematological toxicity or other complications. Overall, 74.3% of patients graded the cosmetic effect as excellent or good. The LRR for pre-excision IORT was 3.0%, whereas that of post-excision IORT was 2.8% (pre-IORT vs. post-IORT, p=0.772). Distant metastases rate was 2.3% for pre-IORT and 1.8% for post-IORT (pre-IORT vs. post-IORT, p=0.692). The cancer-related death rate was 0.7% for pre-IORT and 0.0% for post-IORT (pre-IORT vs. post-IORT, p=0.899). The DFS rate was 94.7% in the pre-IORT group and 95.3% in the post-IORT group. (p=0.672). The LRR was 2.4%, whereas the OS rate was 99.5% after adjusting for the age of patients according to the recommended criteria by the American Society of Therapeutic Radiation Oncology (ASTRO), and the DFS rate was 98.1%.Conclusions: IORT signi cantly reduced the treatment time while preserving a high degree of locoregional control and cosmetic effects. Novelty And ImpactThese current studies mainly included non-Asians and thus lack adequate evidence to support the value of IORT in Asian patients with breast cancer. This study is the rst multicentered, "real-world" retrospective study with the largest number of patients and the longest follow-up time in Chinese patients with breast cancer.

show abstract

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

Cited by 14 publications

References 34 publications

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

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

Radiotherapy-Induced Fatigue in Breast Cancer Patients

Long-Term Outcomes of Intraoperative Radiotherapy for Early-Stage Breast Cancer in China: A Multicenter Real-World Study

Contact Info

Product

Resources

About