Quality of life in women undergoing breast irradiation in a randomized controlled clinical trial evaluating different tumor bed boost fractionations

Publication date: Available online 6 February 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Morgan A. Finkel, Benjamin T. Cooper, Xiaochun Li, M. Fenton-Kerimian, Judith D. Goldberg, Silvia C. Formenti
Purpose/ObjectiveTo identify differences in breast cancer, patient reported quality of life (QOL) between two radiation tumor bed boost dose regimens.Methods and MaterialsFour hundred patients with Stage 0, I, or II breast cancer who underwent segmental mastectomy with sentinel node biopsy and/or axillary node dissection were treated with either a daily or weekly boost. Patients were treated prone to 40.5 Gy/15 fractions to the whole breast, five days a week. Patients were randomized to a concomitant daily boost to the tumor bed of 0.5 Gy, or a weekly boost of 2 Gy on Friday. Patients completed six validated QOL survey instruments at baseline, last week of treatment (3 weeks), 45-60 days from the completion of radiation treatment, and at 2-year follow-up.ResultsThere were no statistically significance differences in responses to the six QOL instruments between the daily and weekly radiation boost regimens, even after adjustment for important covariates. However, several changes in responses over time occurred in both arms, including worsening functional status, cosmetic status and breast specific pain at the end of treatment as compared to before and 45-60 days after the conclusion of treatment.ConclusionsWhole breast, prone intensity modulated radiation has similar outcomes in QOL measures whether given with a daily or weekly boost. This trial has generated the foundation for a current study of weekly versus daily radiation boost in women with early breast cancer in which three dimensional conformal radiation is allowed as a prospective stratification factor.

Teaser

This study aimed to identify differences in breast cancer patient reported QOL between two radiation tumor bed boost dose regimens. Patients completed six validated QOL instruments at specified times during and after treatment. We found that whole breast, prone IMRT similarly affects QOL whether given as a daily or weekly boost. This trial has generated the foundation for a current study of weekly versus daily radiation boost using 3D conformal radiotherapy.


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