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Patient-reported outcomes of catheter-based accelerated partial breast brachytherapy and whole breast irradiation, a single institution experience

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Fig. 1

Abbreviations

APBI:

Accelerated partial breast irradiation

WBI:

Whole breast irradiation

PRO:

Patient-reported outcomes

DCIS:

Ductal carcinoma in situ

LASA:

Linear analog scale assessment

HBCS:

Harvard breast cosmesis scale

PRO-CTCAE:

Patient-reported outcomes version of the common terminology criteria for adverse events

BCTOS:

Breast cancer treatment outcome scale

QoL:

Quality of life

BCT:

Breast conserving therapy

IMRT:

Intensity modulated radiation therapy

ER:

Estrogen receptor

CT:

Computed tomography

PTV:

Planning target volume

HDR:

High-dose rate

CTV:

Clinical target volume

IRB:

Institutional review board

HR-QoL:

Health-related quality of life

IQR:

Interquartile range

GEC-ESTRO:

Groupe européen de curiethérapie of european society for radiotherapy and oncology

NSABP:

National surgical adjuvant breast and bowel project

References

  1. Clarke M 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(9503):2087–2106

    Article  CAS  PubMed  Google Scholar 

  2. Correa C et al (2017) Accelerated partial breast irradiation: executive summary for the update of an ASTRO evidence-based consensus statement. Pract Radiat Oncol 7(2):73–79

    Article  PubMed  Google Scholar 

  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 CANCER

  4. Livi L et al (2015) Accelerated partial breast irradiation using intensity-modulated radiotherapy versus whole breast irradiation: 5-year survival analysis of a phase 3 randomised controlled trial. Eur J Cancer 51(4):451–463

    Article  PubMed  Google 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):229–238

    Article  PubMed  Google Scholar 

  6. Bitter SM et al (2016) WBRT versus APBI: an interim report of patient satisfaction and outcomes. J Contemp Brachyther 8(1):17–22

    Article  Google Scholar 

  7. Garsa AA et al (2013) A prospective longitudinal clinical trial evaluating quality of life after breast-conserving surgery and high-dose-rate interstitial brachytherapy for early-stage breast cancer. Int J Radiat Oncol Biol Phys 87(5):1043–1050

    Article  PubMed  PubMed Central  Google Scholar 

  8. He ZY et al (2012) A comparison of quality of life of early breast cancer patients treated with accelerated partial breast irradiation versus whole breast irradiation in China. Breast Cancer Res Treat 133(2):545–552

    Article  PubMed  Google Scholar 

  9. Marta GN et al (2015) Accelerated partial irradiation for breast cancer: systematic review and meta-analysis of 8653 women in eight randomized trials. Radiother Oncol 114(1):42–49

    Article  PubMed  Google Scholar 

  10. Meattini I et al (2017) Accelerated partial breast irradiation using intensity modulated radiotherapy versus whole breast irradiation: health-related quality of life final analysis from the Florence phase 3 trial. Eur J Cancer 76:17–26

    Article  PubMed  Google Scholar 

  11. Perrucci E et al (2015) Quality of life and cosmesis after breast cancer: whole breast radiotherapy versus partial breast high-dose-rate brachytherapy. Tumori 101(2):161–167

    Article  PubMed  Google Scholar 

  12. Wadasadawala T et al (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):668–675

    Article  CAS  Google Scholar 

  13. Perez M et al (2017) Accelerated partial breast irradiation compared with whole breast radiation therapy: a breast cancer cohort study measuring change in radiation side-effects severity and quality of life. Breast Cancer Res Treat 162(2):329–342

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Olivotto IA et al (2013) Interim cosmetic and toxicity results from RAPID: a randomized trial of accelerated partial breast irradiation using three-dimensional conformal external beam radiation therapy. J Clin Oncol 31(32):4038–4045

    Article  PubMed  Google Scholar 

  15. Manoharan SR et al (2010) Dosimetry evaluation of SAVI-based HDR brachytherapy for partial breast irradiation. J Med Phys 35(3):131–136

    Article  PubMed  PubMed Central  Google Scholar 

  16. Vaidya JS et al (2010) Targeted intraoperative radiotherapy versus whole breast radiotherapy for breast cancer (TARGIT-A trial): an international, prospective, randomised, non-inferiority phase 3 trial. Lancet 376(9735):91–102

    Article  PubMed  Google Scholar 

  17. Veronesi U et al (2013) Intraoperative radiotherapy versus external radiotherapy for early breast cancer (ELIOT): a randomised controlled equivalence trial. Lancet Oncol 14(13):1269–1277

    Article  PubMed  Google Scholar 

  18. Harris JR et al (1979) Analysis of cosmetic results following primary radiation therapy for stages I and II carcinoma of the breast. Int J Radiat Oncol Biol Phys 5(2):257–261

    Article  CAS  PubMed  Google Scholar 

  19. Krishnan L et al (2001) Form or function? Part 2. Objective cosmetic and functional correlates of quality of life in women treated with breast-conserving surgical procedures and radiotherapy. Cancer 91(12):2282–2287

    Article  CAS  PubMed  Google Scholar 

  20. Stanton AL, Krishnan L, Collins CA (2001) Form or function? part 1. subjective cosmetic and functional correlates of quality of life in women treated with breast-conserving surgical procedures and radiotherapy. Cancer 91(12):2273–2281

    Article  CAS  PubMed  Google Scholar 

  21. Hieken TJ et al (2016) A novel treatment schedule for rapid completion of surgery and radiation in early-stage breast cancer. Ann Surg Oncol 23(10):3297–3303

    Article  PubMed  Google 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):392–406

    Article  PubMed  Google 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):259–268

    Article  PubMed  Google 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):1054–1059

    Article  PubMed  PubMed Central  Google Scholar 

  25. Shaitelman SF et al (2017) American brachytherapy society task group report: long-term control and toxicity with brachytherapy for localized breast cancer. Brachytherapy 16(1):13–21

    Article  PubMed  Google Scholar 

  26. Baruch Y, Holtom BC (2008) Survey response rate levels and trends in organizational research. Hum Relat 61(8):1139–1160

    Article  Google 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

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Funding

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).

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    Authors and Affiliations

    1. Department of Radiation Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

      Krishan R. Jethwa, Mohamed M. Kahila, David M. Routman, Geralyn M. Pumper, Kimberly S. Corbin, Sean S. Park & Robert W. Mutter

    2. Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

      Kristin C. Mara, William S. Harmsen & Jeff A. Sloan

    3. Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA

      Kathryn J. Ruddy

    4. Department of Surgery, Mayo Clinic, Rochester, MN, USA

      Tina J. Hieken

    Authors
    1. Krishan R. Jethwa
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    Correspondence to Robert W. Mutter.

    Additional information

    Krishan R. Jethwa, MD, Mohamed M. Kahila, MBBCh, Sean S. Park, MD, PhD, Robert W. Mutter, MD these are authors contributed equally.

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    Jethwa, K.R., Kahila, M.M., Mara, K.C. et al. Patient-reported outcomes of catheter-based accelerated partial breast brachytherapy and whole breast irradiation, a single institution experience. Breast Cancer Res Treat 169, 189–196 (2018). https://doi.org/10.1007/s10549-018-4665-6

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    • DOI: https://doi.org/10.1007/s10549-018-4665-6

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