Breast Cancer Research and Treatment

, Volume 133, Issue 2, pp 545–552 | Cite as

A comparison of quality of life of early breast cancer patients treated with accelerated partial breast irradiation versus whole breast irradiation in China

  • Zhen-Yu He
  • Qin Tong
  • San-Gang Wu
  • Feng-Yan Li
  • Huan-Xin Lin
  • Xun-Xing Guan
Preclinical study


To compare quality of life (QoL) of early breast cancer patients treated with either accelerated partial breast irradiation (APBI) or whole breast irradiation (WBI) after breast-conserving therapy in China. The functional assessment of chronic illness therapy—Breast, traditional Chinese version 4 (FACT-B) instruments were given to 84 women (31 APBI and 53 WBI) who attended the radiotherapy clinic between July 2006 and May 2009 at Cancer Center of Sun Yat-sen University. Baseline characteristics and Karnofsky performance status scores were not different between the two groups. The median follow-up period in the APBI group was 29 versus 34 months in the WBI group. The APBI group scores in the physical domain, functional domain, social domain, and breast-specific concerns of FACT-B were 23.01 ± 3.91, 17.97 ± 4.99, 20.87 ± 4.80, and 22.55 ± 5.45, respectively, and were not significantly different from those of the WBI group (22.80 ± 3.50, 17.50 ± 4.40, 20.13 ± 5.31, 23.81 ± 4.65, respectively, P = 0.987, P = 0.476, P = 0.442, P = 0.330, respectively). However, the scores of the APBI group with respect to the emotional domains were lower compared to those of the WBI group (16.84 ± 3.86 vs. 19.47 ± 3.45, respectively, P = 0.002). Compared with women who underwent WBI, women treated with APBI were shown to have no significantly better QoL outcome, and yet had worse emotional response to their treatment.


Quality of life (QoL) Accelerated partial breast irradiation (APBI) Whole breast irradiation (WBI) Breast cancer 


Conflict of interest

No any actual or potential conflicts of interest exist.


  1. 1.
    Chen K, He M, Dong S, Wang J (2002) Incidence, mortality and survival rates of female breast cancer in Tianjin. China Zhonghua Zhong Liu Za Zhi 24(6):573–575Google Scholar
  2. 2.
    Hong Kong Cancer Registry. Available online at: cancereg/eng/default.asp. Accessed on Feb 1 2008
  3. 3.
    Sanders ME, Scroggins T, Ampil FL, Li BD (2007) Accelerated partial breast irradiation in early-stage breast cancer. J Clin Oncol 25:996–1002PubMedCrossRefGoogle Scholar
  4. 4.
    Fischer B, Jeong J-H, Anderson S, Bryant J, Fisher ER, Wolmark N (2002) Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and radiation. N Engl J Med 8:567–575CrossRefGoogle Scholar
  5. 5.
    Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, Aguilar M, Marubini E (2002) Twenty-year follow-up of a surgery with radical mastectomy for early breast cancer. N Engl J Med 16:1227–1232CrossRefGoogle Scholar
  6. 6.
    Owen JR, Ashton A, Bliss JM, Homewood J, Harper C, Hanson J, Haviland J, Bentzen SM, Yarnold JR (2006) Effect of radiotherapy fraction size on tumor control in patients with early-stage breast cancer after local tumor excision: long-term results of a randomised trial. Lancet Oncol 7:467–471PubMedCrossRefGoogle Scholar
  7. 7.
    Clarke M, Collins R, Darby S et al (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366:2087–2106PubMedGoogle Scholar
  8. 8.
    Polgár C, Fodor J, Major T, Németh G, Lövey K, Orosz Z, Sulyok Z, Takácsi-Nagy Z, Kásler M (2007) Breast-conserving treatment with partial or whole breast irradiation for low-risk invasive breast carcinoma-5-year results of a randomized trial. Int J Radiat Oncol Biol Phys 69:694–702PubMedCrossRefGoogle Scholar
  9. 9.
    Smith BD, Arthur DW, Buchholz TA, Haffty BG, Hahn CA, Hardenbergh PH, Julian TB, Marks LB, Todor DA, Vicini FA, Whelan TJ, White J, Wo JY, Harris JR (2009) Accelerated partial breast irradiation consensus statement from the American society for radiation oncology (ASTRO). Int J Radiat Oncol Biol Phys 74(4):987–1001PubMedCrossRefGoogle Scholar
  10. 10.
    Polgár C, Major T, Fodor J, Sulyok Z, Somogyi A, Lövey K, Németh G, Kásler M (2010) Accelerated partial-breast irradiation using high-dose-rate interstitial brachytherapy: 12-year update of a prospective clinical study. Radiother Oncol 94(3):274–279PubMedCrossRefGoogle Scholar
  11. 11.
    Taghian AG, Kozak KR, Adams J, Mitchell C, Hasan Y, Grills I, Kestin L, Schell S, Goldstein NS, Kunzman J, Gilbert S, Martinez A (2005) Accelerated partial-breast irradiation (APBI) using protons for patients with early-stage breast cancer: a comparison with 3D conformal photon/electron based treatment. Int J Radiat Oncol Biol Phys 63(S1):S8–S9CrossRefGoogle Scholar
  12. 12.
    Livi L, Buonamici FB, Simontacchi G, Scotti V, Fambrini M, Compagnucci A, Paiar F, Scoccianti S, Pallotta S, Detti B, Agresti B, Talamonti C, Mangoni M, Bianchi S, Cataliotti L, Marrazzo L, Bucciolini M, Biti G (2010) Accelerated partial breast irradiation with IMRT: new technical approach and interim analysis of acute toxicity in a phase iii randomized clinical trial. Int J Radiat Oncol Biol Phys 77(2):509–515PubMedCrossRefGoogle Scholar
  13. 13.
    Vicini FA, Chen P, Wallace M, Mitchell C, Hasan Y, Grills I, Kestin L, Schell S, Goldstein NS, Kunzman J, Gilbert S, Martinez A (2007) Interim cosmetic results and toxicity using 3D conformal external beam radiotherapy to deliver accelerated partial breast irradiation in patients with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys 69(4):1124–1130PubMedCrossRefGoogle Scholar
  14. 14.
    Antonucci JV, Wallace M, Goldstein NS, Kestin L, Chen P, Benitez P, Dekhne N, Martinez A, Vicini F (2009) Differences in patterns of failure in patients treated with accelerated partial breast irradiation versus whole-breast irradiation: a matched-pair analysis with 10-year follow-up. Int J Radiat Oncol Biol Phys 74(2):447–452PubMedCrossRefGoogle Scholar
  15. 15.
    Wadasadawala T, Sarin R, Budrukkar A, Jalali R, Munshi A, Badwe R (2009) Accelerated partial-breast irradiation vs conventional whole-breast radiotherapy in early breast cancer: a case-control study of disease control, cosmesis, and complications. J Cancer Res Ther 5(2):93–101PubMedCrossRefGoogle Scholar
  16. 16.
    Vicini F, Winter K, Wong J, Pass H, Rabinovitch R, Chafe S, Arthur D, Petersen I, White J, McCormick B (2010) Initial efficacy results of RTOG 0319: three-dimensional conformal radiation therapy (3D-CRT) confined to the region of the lumpectomy cavity for stage I/II breast carcinoma. Int J Radiat Oncol Biol Phys 77(4):1120–1127PubMedCrossRefGoogle Scholar
  17. 17.
    Wadasadawala T, Budrukkar A, Chopra S, Badwe R, Hawaldar R, Parmar V, Jalali R, Sarin R (2009) Quality of life after accelerated partial breast irradiation in early breast Cancer: matched pair analysis with protracted whole breast radiotherapy. Clin Oncol 21(9):668–675CrossRefGoogle Scholar
  18. 18.
    Belkacémi Y, Chauvet M, Giard S, Villette S, Lacornerie T, Bonodeau F, Baranzelli MC, Bonneterre J, Lartigau E (2009) Partial breast irradiation as sole therapy for low risk breast carcinoma: Early toxicity, cosmesis and quality of life results of a Mammo Site brachytherapy phase II study. J Radiother Oncol 90(1):23–29CrossRefGoogle Scholar
  19. 19.
    Sher DJ, Wittenberg E, Suh WW, Taghian AG, Punglia RS (2009) Partial-breast irradiation versus whole-breast irradiation for early-stage breast cancer: a cost-effectiveness analysis. Int J Radiat Oncol Biol Phys 74(2):440–446PubMedCrossRefGoogle Scholar
  20. 20.
    Vicini F, Winter K, Straube W, Wong J, Pass H, Rabinovitch R, Chafe S, Arthur D, Petersen I, McCormick B (2005) A phase I/II trial to evaluate three-dimensional conformal radiation therapy confined to the region of the lumpectomy cavity for Stage I/II breast carcinoma: initial report of feasibility, reproducibility of radiation therapy oncology group (RTOG) study 0319. Int J Radiat Oncol Biol Phys 63(5):1531–1537PubMedCrossRefGoogle Scholar
  21. 21.
    Brady MJ, Cella DF, Mo F, Bonomi AE, Tulsky DS, Lloyd SR, Deasy S, Cobleigh M, Shiomoto G (1997) Reliability and validity of the functional assessment of cancer therapy-breast quality-of-life instrument. J Clin Oncol 15(3):974–986PubMedGoogle Scholar
  22. 22.
    Crooks V, Waller S, Smith T, Hahn TJ (1991) The use of the Karnofsky performance scale in determining outcomes and risk in geriatric outpatients. J Gerontol 46:4–139Google Scholar
  23. 23.
    Wojtyna E, Życińska J, Stawiarska P (2007) The influence of cognitive-behaviour therapy on quality of life and self-esteem in women suffering from breast cancer. Rep Pract Oncol Radiother 12(2):109–117CrossRefGoogle Scholar
  24. 24.
    Curran D, van Dongen JP, Aaronson NK, Kiebert G, Fentiman IS, Mignolet F, Bartelink H (1998) Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: results of EORTC trial 10801. The European Organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative Group (BCCG). Eur J Cancer 34(3):307–314PubMedCrossRefGoogle Scholar
  25. 25.
    Flynn C, Mitchell C, Boyea G et al (2007) A comparison of quality of life (QOL) for early stage breast cancer examining various treatment modalities and no chemotherapy. Int J Radiat Oncol Biol Phys 69:S583–S584 AbstractCrossRefGoogle Scholar
  26. 26.
    Sherrill B, Di Leo A, Amonkar MM, Wu Y, Zvirbule Z, Aziz Z, Bines J, Gomez HL (2010) Quality-of-life and quality—adjusted survival (Q-TWiST) in patients receiving lapatinib in combination with paclitaxel as first-line treatment for metastatic breast cancer. Curr Med Res Opin 26(4):767–775PubMedCrossRefGoogle Scholar
  27. 27.
    So WK, Marsh G, Ling WM, Leung FY, Lo JC, Yeung M, Li GK (2010) Anxiety, depression and quality of life among Chinese breast cancer patients during adjuvant therapy. Eur J Oncol Nurs 14(1):17–22PubMedCrossRefGoogle Scholar
  28. 28.
    Col NF, Weber G, Stiggelbout A, Chuo J, D’Agostino R, Corso P (2004) Short-term menopausal hormone therapy for symptom relief: an updated decision model. Arch Intern Med 164(15):1634–1640PubMedCrossRefGoogle Scholar
  29. 29.
    Hiatt JR, Evans SB, Price LL, Cardarelli GA, Dipetrillo TA, Wazer DE (2006) Dose-modeling study to compare external beam techniques from protocol NSABP B-39/RTOG 0413 for patients with highly unfavorable cardiac anatomy. Int J Radiat Oncol Biol Phys 65(5):1368–1374PubMedCrossRefGoogle Scholar
  30. 30.
    Guix B, Lejárcegui JA, Tello JI, Zanón G, Henríquez I, Finestres F, Martínez A, Fernandez-Ibiza J, Quinzaños L, Palombo P, Encinas X, Guix I (2010) Exeresis and brachytherapy as salvage treatment for local recurrence after conservative treatment for breast cancer: results of a ten-year pilot study. Int J Radiat Oncol Biol Phys 78(3):804–810PubMedCrossRefGoogle Scholar
  31. 31.
    Fehlauer F, Tribius S, Höller U, Rades D, Kuhlmey A, Bajrovic A, Alberti W (2003) Long-term radiation sequelae after breast-conserving therapy in women with early-stage breast cancer: an observational study using the LENT-SOMA scoring system. Int J Radiat Oncol Biol Phys 55(3):651–658PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Zhen-Yu He
    • 1
  • Qin Tong
    • 2
  • San-Gang Wu
    • 1
  • Feng-Yan Li
    • 1
  • Huan-Xin Lin
    • 1
  • Xun-Xing Guan
    • 1
  1. 1.State Key Laboratory of Oncology in Southern China, Department of Radiation OncologyCancer Center of Sun Yat-sen UniversityGuangzhouPeople’s Republic of China
  2. 2.Department Of Radiation Oncology, Cancer CenterThe First Affiliated Hosptial Of Nanhua UniversityHengyangChina

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