Quality of Life after Accelerated Partial Breast Irradiation in Early Breast Cancer: Matched Pair Analysis with Protracted Whole Breast Radiotherapy

Wadasadawala, T.; Budrukkar, A.; Chopra, S.; Badwe, R.; Hawaldar, R.; Parmar, V.; Jalali, R.; Sarin, R.

doi:10.1016/j.clon.2009.07.014

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Volume 21, Issue 9 , Pages 668-675, November 2009

Quality of Life after Accelerated Partial Breast Irradiation in Early Breast Cancer: Matched Pair Analysis with Protracted Whole Breast Radiotherapy

T. Wadasadawala
- Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India
A. Budrukkar
- Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India
S. Chopra
- Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India
R. Badwe
- Department of Surgery, Tata Memorial Hospital, Parel, Mumbai, India
R. Hawaldar
- Department of Clinical Research Secretariat, Tata Memorial Hospital, Parel, Mumbai, India
V. Parmar
- Department of Surgery, Tata Memorial Hospital, Parel, Mumbai, India
R. Jalali
- Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India
R. Sarin
- Department of Radiation Oncology, Advanced Centre for Treatment, Research & Education in Cancer, Kharghar, Navi Mumbai, India
- Author for correspondence: R. Sarin, Advanced Centre for Treatment, Research & Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai 410 210, India. Tel: +91-22-27405035; Fax: +91-22-27405080.

Received 30 January 2009; received in revised form 22 July 2009; accepted 23 July 2009.

Abstract

Aims

To compare the quality of life of women with early breast cancer treated with either accelerated partial breast irradiation (APBI) or whole breast radiotherapy (WBRT).

Materials and methods

After matching for the American Brachytherapy Society criteria, the general European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the breast cancer-specific BR23 modules were given to 48 women (23 APBI and 25 WBRT) who attended the radiotherapy clinic between May 2006 and December 2006 at Tata Memorial Hospital.

Results

The median follow-up of patients in both groups was 3 years. The reliability and validity of the English and translated versions of the questionnaires were tested by Cronbach alpha (0.67–0.96) and Pearson's correlation for scale–scale correlation statistic (0.013–0.505). The scores for social functioning and financial difficulties in QLQ-C30 showed a trend towards a better outcome in the APBI group (P=0.025 and 0.019, respectively) and body image in BR23 was significantly better in the APBI group as compared with the WBRT group (P=0.005). When the analysis was restricted to women receiving chemotherapy in order to eliminate the confounding effect of the heterogeneous use of chemotherapy in the WBRT group, the difference in social functioning was not significant. However, financial difficulties and body image showed a trend towards a worse outcome in the WBRT group.

Conclusion

Favourable long-term results of APBI in terms of superior body image perception and lesser financial difficulties compared with WBRT need to be confirmed in larger prospective studies investigating the effect of APBI on quality of life and health economics in different ethnic groups and health care set-ups.

Key words: Accelerated partial breast irradiation (APBI), BR23, early breast cancer (EBC), EORTC QLQ-C30, quality of life (QOL), whole breast radiotherapy (WBRT)