Patient-reported outcomes of catheter-based accelerated partial breast brachytherapy and whole breast irradiation, a single institution experience
Accelerated partial breast irradiation (APBI) and whole breast irradiation (WBI) are treatment options for early-stage breast cancer. The purpose of this study was to compare patient-reported-outcomes (PRO) between patients receiving multi-channel intra-cavitary brachytherapy APBI or WBI.
Between 2012 and 2015, 131 patients with ductal carcinoma in situ (DCIS) or early stage invasive breast cancer were treated with adjuvant APBI (64) or WBI (67) and participated in a PRO questionnaire. The linear analog scale assessment (LASA), harvard breast cosmesis scale (HBCS), PRO-common terminology criteria for adverse events- PRO (PRO-CTCAE), and breast cancer treatment outcome scale (BCTOS) were used to assess quality of life (QoL), pain, fatigue, aesthetic and functional status, and breast cosmesis. Comparisons of PROs were performed using t-tests, Wilcoxon rank-sum, Chi square, Fisher exact test, and regression methods.
Median follow-up from completion of radiotherapy and questionnaire completion was 13.3 months. There was no significant difference in QoL, pain, or fatigue severity, as assessed by the LASA, between treatment groups (p > 0.05). No factors were found to be predictive of overall QoL on regression analysis. BCTOS health-related QoL scores were similar between treatment groups (p = 0.52).The majority of APBI and WBI patients reported excellent/good breast cosmesis, 88.5% versus 93.7% (p = 0.37). Skin color change (p = 0.011) and breast elevation (p = 0.01) relative to baseline were more common in the group receiving WBI.
APBI and WBI were both associated with favorable patient-reported outcomes in early follow-up. APBI resulted in a lesser degree of patient-reported skin color change and breast elevation relative to baseline.
KeywordsBreast Cancer Radiotherapy PROs APBI
Accelerated partial breast irradiation
Whole breast irradiation
Ductal carcinoma in situ
Linear analog scale assessment
Harvard breast cosmesis scale
Patient-reported outcomes version of the common terminology criteria for adverse events
Breast cancer treatment outcome scale
Quality of life
Breast conserving therapy
Intensity modulated radiation therapy
Planning target volume
Clinical target volume
Institutional review board
Health-related quality of life
Groupe européen de curiethérapie of european society for radiotherapy and oncology
National surgical adjuvant breast and bowel project
This project was supported by the Mayo Clinic CTSA through Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH).
- 3.Institute, N.C., NSABP B-39: A randomized phase iii study of conventional whole breast irradiation (wbi) versus partial breast irradiation (pbi) for women with stage 0, I, or II breast CANCERGoogle Scholar
- 5.Strnad V et al (2016) 5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in situ carcinoma of the female breast: a randomised, phase 3, non-inferiority trial. Lancet 387(10015):229–238CrossRefPubMedGoogle Scholar
- 22.Remouchamps VM et al (2003) Significant reductions in heart and lung doses using deep inspiration breath hold with active breathing control and intensity-modulated radiation therapy for patients treated with locoregional breast irradiation. Int J Radiat Oncol Biol Phys 55(2):392–406CrossRefPubMedGoogle Scholar
- 23.Polgar C et al (2017) Late side-effects and cosmetic results of accelerated partial breast irradiation with interstitial brachytherapy versus whole-breast irradiation after breast-conserving surgery for low-risk invasive and in situ carcinoma of the female breast: 5-year results of a randomised, controlled, phase 3 trial. Lancet Oncol 18(2):259–268CrossRefPubMedGoogle Scholar
- 24.Rabinovitch R et al (2016) Long-term update of nrg oncology rtog 0319: a phase 1 and 2 trial to evaluate 3-dimensional conformal radiation therapy confined to the region of the lumpectomy cavity for stage 1 and 2 breast carcinoma. Int J Radiat Oncol Biol Phys 96(5):1054–1059CrossRefPubMedPubMedCentralGoogle Scholar
- 27.ClinicalTrials.gov. A study of accelerated 3 fraction photon,proton or brachytherapy for early invasive and noninvasive breast cancer. https://clinicaltrials.gov/ct2/show/NCT02453737?term=mutter&rank=3