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早期乳腺癌采用部分乳腺质子治疗后患者报告的健康和幸福感的长期改善。

Improved long-term patient-reported health and well-being outcomes of early-stage breast cancer treated with partial breast proton therapy.

机构信息

Department of Radiation Medicine Loma, Linda University Medical Center, Loma Linda, California.

Department of Surgical Oncology, Loma Linda University Medical Center, Loma Linda, California.

出版信息

Cancer Med. 2018 Dec;7(12):6064-6076. doi: 10.1002/cam4.1881. Epub 2018 Nov 19.

Abstract

BACKGROUND

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).

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0868/6308094/6305f855f4e3/CAM4-7-6064-g001.jpg

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