To determine whether a shorter course of radiation treatment may be
associated with an improvement in quality of life (QOL),
investigators at William Beaumont Hospital, Royal Oak, Michigan,
compared the QOL of women with early-stage breast cancer selected for
breast-conserving therapy and external-beam radiation therapy or
brachytherapy. They reported their findings at the American Society
for Therapeutic Radiology and Oncology (ASTRO) meeting.
For a period of 18 months, 56 consecutive patients with breast cancer
were enrolled in a QOL study and were treated with breast-conserving
therapy and radiation therapy at William Beaumont Hospital; 31
patients received brachytherapy alone, and 25 patients received
Patients in both groups were asked to complete the European
Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, a
30-item questionnaire designed to assess function (physical, role,
emotional, cognitive, and social), symptoms (fatigue, pain, nausea,
and vomiting), and global health (dyspnea, insomnia, loss of
appetite, constipation, diarrhea, and financial impact).
Results During the First Week of Therapy
Initially, patients in the study were requested to complete the
QLQ-C30 upon simulation of treatment and during the first week of
treatment. Subsequently, they were asked to complete the
questionnaire 7 weeks after the start of therapy, and again 3, 6, 9,
and 12 months after treatment initiation.
During the first week of treatment, women undergoing external-beam
radiation demonstrated an increase in physical, role, and social
function and nearly statistically significant results in cognitive
function and global health. Conversely, during the first week of
treatment, women undergoing brachytherapy alone experienced an
increase in fatigue, pain, and loss of appetite. According to the
investigators, these results may be attributable to aspects of the
surgical procedure, such as the use of general anesthesia, the
narcotic pain regimen, and decreased mobility related to the template
and its location.
At week 7, women undergoing external-beam radiation experienced an
increase in fatigue, constipation, and financial impact, possibly as
a result of the protracted treatment course and increased cost
relative to brachytherapy.
At 6 months, patients who received external-beam radiation therapy
experienced an increase in breast pain, predominantly at the site of
tumor excision. In addition, constipation was significantly more
common in the patients given external radiation at months 6, 9, and 12.
In conclusion, patients in both groups demonstrated no statistically
significant differences in QOL at 3, 6, 9, and 12 months after
treatment with the exception of breast pain/tenderness and
constipation. However, the investigators warn that the results may
change once complete patient accrual and follow-up are achieved.