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

• Published in: Breast (Edinburgh) 2019-08, Vol.46, p.32-39
• Main Authors: Jacobs, D.H.M., Horeweg, N., Straver, M., Roeloffzen, E.M.A., Speijer, G., Merkus, J., van der Sijp, J., Mast, M.E., Fisscher, U., Petoukhova, A.L., Zwanenburg, A.G., Marijnen, C.A.M., Koper, P.C.M.
• Format: Article
• Language: English
• Subjects: Accelerated partial breast irradiation; Aged; Breast cancer; Breast Neoplasms - psychology; Breast Neoplasms - radiotherapy; Cross-Sectional Studies; Elderly; Female; Humans; Intraoperative Care - methods; Intraoperative Care - psychology; Intraoperative radiotherapy; Longitudinal Studies; Mastectomy, Segmental - methods; Mastectomy, Segmental - psychology; Middle Aged; Postoperative Period; Prospective Studies; Quality of Life; Radiotherapy Dosage; Radiotherapy, Adjuvant - methods; Radiotherapy, Adjuvant - psychology; Treatment Outcome
• ISSN: 0960-9776; 1532-3080
• DOI: 10.1016/j.breast.2019.04.006

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). 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 × 23.3 Gy) or photon EB-APBI (10 × 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. 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). 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. •Both external-beam and intraoperative partial breast irradiation were well tolerated.•Most patients experienced mild temporary decrease in quality of life after treatment.•Quality of life (QoL) of patients recovered rapidly within 3 months after treatment.•No significant differences in QoL at 1 year after treatment between groups.•Comorbidity and systemic therapy add more impact than radiation therapy type on QoL.