Original Research ARTICLE
A Prospective Analysis of Quality of Life and Toxicity Outcomes in Treating Early Breast Cancer with Breast Conservation Therapy and Intraoperative Radiation Therapy
- 1MedStar Georgetown University Hospital, United States
Introduction: Intraoperative radiation therapy (IORT) is a minimally invasive radiation option for select patients with early stage breast cancer. This prospective, single institution, pilot study summarizes patient-reported quality of life (QoL) outcomes and clinician-reported toxicity following IORT following breast conservation therapy.
Methods: Forty-nine patients were enrolled in a prospective study from 2013 until 2015 to assess QoL and toxicity following breast conservation therapy and IORT. Nine patients did not meet criteria for IORT alone on final pathology and required whole breast irradiation afterwards. These patients were evaluated separately. Validated QoL questionnaires were provided to patients at one-week, one-month, and subsequent six-month intervals for two years. Radiation-related toxicity symptoms were evaluated by clinicians at the same time intervals. Likert scale responses were converted to continuous variables to depict patient-reported and clinician-reported outcomes.
Results: Outcomes were analyzed as weighted averages of the Likert scale for each symptom. Responses for negative QoL symptoms ranged largely from 0 (none) to 2 (moderate). Responses for positive QoL symptoms ranged largely from 3 (quite a bit) to 4 (very much). Seventy-five percent of patients developed a toxicity; however, 99% of the toxicities were grades 1 and 2. All toxicities demonstrated a downward trend over time, with the exception of breast fibrosis and nodularity, which increased over time. There were no local recurrences upon two-year follow up.
Conclusion: Early stage breast cancer treated with IORT yields favorable QoL outcomes and minimal toxicity profiles with adequate short-term local control.
Keywords: Quality of Life, Radiation, Intraoperative radiation, Toxicity, Breast conservation
Received: 25 Aug 2018;
Accepted: 05 Nov 2018.
Edited by:Brian J. Czerniecki, Moffitt Cancer Center, United States
Reviewed by:Laura Kruper, City of Hope National Medical Center, United States
Shayna L. Showalter, University of Virginia, United States
Copyright: © 2018 Wang, Sosin, Gupta, Costellic, Gulla, Bartholomew, Hechenbleikner, Collins, Rudra, Collins, Chaldekas, Seevaratnam, Langan, Willey and Tousimis. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Dr. Michael Sosin, MedStar Georgetown University Hospital, Washington D.C., United States, email@example.com
Dr. Eleni Tousimis, MedStar Georgetown University Hospital, Washington D.C., United States, Eleni.A.Tousimis@gunet.georgetown.edu