Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India.
Clin Oncol (R Coll Radiol). 2009 Nov;21(9):668-75. doi: 10.1016/j.clon.2009.07.014. Epub 2009 Sep 5.
To compare the quality of life of women with early breast cancer treated with either accelerated partial breast irradiation (APBI) or whole breast radiotherapy (WBRT).
After matching for the American Brachytherapy Society criteria, the general European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the breast cancer-specific BR23 modules were given to 48 women (23 APBI and 25 WBRT) who attended the radiotherapy clinic between May 2006 and December 2006 at Tata Memorial Hospital.
The median follow-up of patients in both groups was 3 years. The reliability and validity of the English and translated versions of the questionnaires were tested by Cronbach alpha (0.67-0.96) and Pearson's correlation for scale-scale correlation statistic (0.013-0.505). The scores for social functioning and financial difficulties in QLQ-C30 showed a trend towards a better outcome in the APBI group (P=0.025 and 0.019, respectively) and body image in BR23 was significantly better in the APBI group as compared with the WBRT group (P=0.005). When the analysis was restricted to women receiving chemotherapy in order to eliminate the confounding effect of the heterogeneous use of chemotherapy in the WBRT group, the difference in social functioning was not significant. However, financial difficulties and body image showed a trend towards a worse outcome in the WBRT group.
Favourable long-term results of APBI in terms of superior body image perception and lesser financial difficulties compared with WBRT need to be confirmed in larger prospective studies investigating the effect of APBI on quality of life and health economics in different ethnic groups and health care set-ups.
比较采用加速部分乳房照射(APBI)与全乳房放疗(WBRT)治疗早期乳腺癌的女性生活质量。
根据美国近距离放射治疗学会(ABS)标准进行匹配后,2006 年 5 月至 12 月期间在塔塔纪念医院放疗科就诊的 48 名女性(APBI 组 23 例,WBRT 组 25 例)接受了一般欧洲癌症研究与治疗组织(EORTC)QLQ-C30 问卷和乳腺癌专用 BR23 模块的调查。
两组患者的中位随访时间均为 3 年。通过 Cronbach alpha(0.67-0.96)和量表间相关统计的 Pearson 相关系数(0.013-0.505)对问卷的英文和翻译版本进行了可靠性和有效性测试。QLQ-C30 中的社会功能和经济困难评分显示 APBI 组的结果呈改善趋势(分别为 P=0.025 和 0.019),BR23 中的身体形象评分在 APBI 组明显优于 WBRT 组(P=0.005)。当分析仅限于接受化疗的女性时,为了消除 WBRT 组化疗使用的混杂影响,社会功能的差异没有统计学意义。然而,经济困难和身体形象在 WBRT 组的结果呈恶化趋势。
APBI 在身体形象感知方面具有良好的长期结果,与 WBRT 相比经济困难更小,但需要在不同种族和医疗保健环境中进行的评估 APBI 对生活质量和健康经济学影响的更大规模前瞻性研究中加以证实。