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Accelerated radiotherapy for breast cancer does not harm quality of life
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Accelerated partial breast irradiation did not worsen patients’ quality of life compared with whole breast irradiation, according to 5-year results of a randomized controlled phase 3 study conducted in Europe.
The standard of treatment following breast-conserving surgery for women with early-stage breast cancer is whole breast irradiation, which can take 3 to 6 weeks. However, accelerated partial breast irradiation can shorten treatment to just a single week.
“This treatment focuses only on the area of the breast where the tumor has been removed and so it offers a number of advantages,” Rebekka Schafer, MD, clinician in radiation oncology at University Hospital Wurzburg in Germany, said in a press release. “It allows us to deliver a higher dose of radiation to a smaller area, which means the course of treatment is shortened from 3 to 6 weeks down to 1 week or less. It also makes it easier to avoid unnecessary radiation to other parts of the body, such as the heart and lungs. However, compared [with] external radiotherapy, this is a more invasive treatment, so we wanted to see how it affected women’s quality of life and their symptoms, both when they are treated and in the longer term.”
The analysis included women from 16 hospitals in seven countries in Europe who researchers randomly assigned to either accelerated partial breast irradiation at a dose of 50 Gy with a boost of 10 Gy using multicatheter brachytherapy over 4 to 5 days (n = 633) or whole breast irradiation over the course of 6 to 6.5 weeks (n = 551) between April 2004 and July 2009.
Long-term follow-up in the study remained ongoing at the time of publication; however, the current report focused on 5-year quality-of-life results based on patient questionnaires.
Baseline questions were available from 53% of the accelerated group and 57% of the whole breast irradiation group. At that time, both groups had similar global health status, with a mean score of 65.5 (standard deviation, 20.6) in the accelerated group, compared with 64.6 (standard deviation, 19.6) in the whole breast irradiation group.
At 5 years, global health status remained stable, with a mean score of 66.2 (standard deviation, 22.2) in the accelerated group and 66 (standard deviation, 21.8) in the whole breast irradiation group.
However, researchers observed a moderate difference between the two groups in the breast symptom scale. Patients who received whole breast irradiation had significantly worse scores immediately after therapy than patients who received accelerated therapy (difference in mean scores, 13.6; 95% CI, 9.7-17.5), as well as at 3 months of follow-up (difference, 12.7; 95% CI, 9.8-15.6; P < .001 for both).
“More and more women are surviving breast cancer for longer and longer, so we need to be sure that treatments do not detract from their quality of life in the long term,” Schafer said. “Research like this is vital because it allows us to offer treatment choices. For a variety of reasons, patients may find it difficult to manage a treatment schedule that lasts up to 6 weeks. They may have to travel a long way to reach [the] hospital, or they may wish to return to work as soon as possible, so they might prefer a treatment that can be carried out in a week or less.” – by Andy Polhamus
Disclosures: Schafer reports no relevant financial disclosures. Please see the study for a list of all other authors’ relevant financial disclosures.
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