Quality of Life Apparently Unaffected by Duration of Radiation Therapy for Breast Cancer

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 external-beam radiation.

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.

Later Results

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.