Department of Radiation Medicine Loma, Linda University Medical Center, Loma Linda, California.
Department of Surgical Oncology, Loma Linda University Medical Center, Loma Linda, California.
Cancer Med. 2018 Dec;7(12):6064-6076. doi: 10.1002/cam4.1881. Epub 2018 Nov 19.
Because early-stage breast cancer can be treated successfully by a variety of breast-conservation approaches, long-term quality of life (QoL) is an important consideration in assessing treatment outcomes for these patients. This study compares patient-reported QoL outcomes among women with stage 0-2 disease treated via lumpectomy followed by whole breast irradiation (WBI) or partial breast proton irradiation (PBPT).
In this cross-sectional study, 129 participants evaluated QoL several years post-treatment by responding to subjective instruments, including established scalar questionnaires and self-report measures. Responses were averaged between the two groups.
At 6.5 years (median) postdiagnosis, participants' demographic, and clinical characteristics were similar. Patient-reported outcomes were reported as mean scale scores for the two groups, all displaying significant differences favoring PBPT, including: cosmetic breast cancer treatment outcome scale (BCTOS) (PBPT mean 1.45, WBI mean 1.88, P < 0.001); breast pain (PBPT mean 1.30, WBI mean 1.67, P < 0.05); breast texture (BPT mean 1.44, WBI mean 1.91, P < 0.001); clothing fit (PBPT mean 1.06, WBI 1.46, P < 0.001); fatigue (PBPT mean 2.24, WBI mean 3.77, P < 0.002); impact of daily life fatigue on personal relations (OBPT mean 0.83, WBI mean 2.15, P < 0.001); and self-consciousness (appearance dissatisfaction) (PBPT mean 1.38, WBI mean 1.77, P < 0.004).
Patients' responses suggest that PBPT is associated with improved overall QoL compared to standard whole breast treatment. These self-perceptions are reported by patients who are 5-10 years post-treatment, and that PBPT may enhance QoL in a multitude of interrelated ways.
由于早期乳腺癌可以通过多种保乳方法成功治疗，因此长期生活质量（QoL）是评估这些患者治疗结果的重要考虑因素。本研究比较了接受保乳手术后行全乳照射（WBI）或部分乳腺质子照射（PBPT）治疗的 0-2 期疾病女性患者的患者报告 QoL 结果。
在这项横断面研究中，129 名参与者在治疗后数年通过回答主观量表来评估 QoL，包括已建立的标度问卷和自我报告措施。两组之间的反应进行了平均。
在诊断后 6.5 年（中位数），参与者的人口统计学和临床特征相似。患者报告的结果作为两组的平均量表评分报告，所有评分均显示 PBPT 明显优于 WBI，包括：美容乳腺癌治疗结果量表（BCTOS）（PBPT 平均值为 1.45，WBI 平均值为 1.88，P<0.001）；乳房疼痛（PBPT 平均值为 1.30，WBI 平均值为 1.67，P<0.05）；乳房质地（BPT 平均值为 1.44，WBI 平均值为 1.91，P<0.001）；服装合身（PBPT 平均值为 1.06，WBI 平均值为 1.46，P<0.001）；疲劳（PBPT 平均值为 2.24，WBI 平均值为 3.77，P<0.002）；日常生活疲劳对个人关系的影响（OBPT 平均值为 0.83，WBI 平均值为 2.15，P<0.001）；和自我意识（外观不满）（PBPT 平均值为 1.38，WBI 平均值为 1.77，P<0.004）。
患者的反应表明，与标准全乳治疗相比，PBPT 与总体 QoL 的提高相关。这些自我认知是在治疗后 5-10 年的患者中报告的，并且 PBPT 可能通过多种相互关联的方式提高 QoL。
