Wadasadawala Tabassum, Maitre Priyamvada, Sinha Shwetabh, Parmar Vani, Pathak Rima, Gaikar Mithila, Verma Shalini, Sarin Rajiv
Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, India.
Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai.
J Contemp Brachytherapy. 2021 Aug;13(4):387-394. doi: 10.5114/jcb.2021.107690. Epub 2021 Jul 10.
The aim of this study was to compare patient-reported quality of life (QOL) scores after accelerated partial breast irradiation (APBI) using interstitial brachytherapy vs. external beam whole breast radiotherapy (WBRT) for breast cancer.
Women with breast cancer treated with WBRT or APBI after breast conservation surgery were enrolled in this prospective study. Single cross-sectional QOL assessment was performed using EORTC QLQ-C30 and BR-23 questionnaires. Patients treated with APBI were propensity-score matched to similar cohort of patients treated with WBRT. QOL scores were analyzed for the entire unmatched cohort and compared between the two matched cohorts using Student's two-tailed -test. -value of < 0.05 was considered statistically significant, and a 10-point difference between mean scores was considered clinically meaningful.
A total of 64 APBI patients were matched with 99 WBRT patients out of the entire study cohort of 320 cases. QOL scores for functional scales of QLQ-C30 were similar between the two groups for both matched and unmatched cohorts, while symptom scores of QLQ-C30 did not show any clinically significant difference. Functional scales of BR-23 did not show any clinical or statistically significant difference. Among symptom scales of BR-23, scores were similar for APBI and WBRT groups except for a worse score of "upset by hair loss" sub-scale in the brachytherapy group of the matched cohort (51.9 vs. 22.7, = 0.006).
Patients undergoing APBI reported similar QOL compared to WBRT when matched for various factors.
本研究旨在比较采用组织间近距离放疗的加速部分乳腺照射（APBI）与全乳外照射放疗（WBRT）治疗乳腺癌后患者报告的生活质量（QOL）评分。
本前瞻性研究纳入了保乳手术后接受WBRT或APBI治疗的乳腺癌女性患者。使用欧洲癌症研究与治疗组织（EORTC）QLQ-C30和BR-23问卷进行单横断面QOL评估。接受APBI治疗的患者按倾向得分与接受WBRT治疗的类似队列患者进行匹配。对整个未匹配队列的QOL评分进行分析，并使用学生双尾检验比较两个匹配队列之间的评分。P值<0.05被认为具有统计学意义，平均评分之间10分的差异被认为具有临床意义。
在320例的整个研究队列中，共有64例APBI患者与99例WBRT患者进行了匹配。对于匹配和未匹配队列，两组之间QLQ-C30功能量表的QOL评分相似，而QLQ-C30症状评分未显示出任何临床显著差异。BR-23功能量表未显示出任何临床或统计学显著差异。在BR-23症状量表中，APBI组和WBRT组的评分相似，但匹配队列的近距离放疗组“因脱发而烦恼”子量表的评分更差（51.9对22.7，P = 0.006）。
在针对各种因素进行匹配后，接受APBI治疗的患者报告的QOL与接受WBRT治疗的患者相似。
