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Early breast cancer: Patients report favorable quality of life after partial breast irradiation

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Brachytherapy-based APBI: Results meaningful for women

This study by Schäfer and colleagues supports results of earlier and smaller studies showing promising quality of life results following accelerated partial breast irradiation (APBI) using multicatheter brachytherapy, according to Reshma Jagsi, MD.

“The results suggest that for quality of life, multicatheter brachytherapy-based APBI does not adversely affect outcomes, compared with whole breast irradiation,” Dr. Jagsi wrote in an editorial accompanying the article.

Dr. Reshma Jagsi of the University of Michigan

Dr. Reshma Jagsi

Dr. Jagsi highlighted “modest but significant” differences favoring APBI for early breast symptoms, both right after treatment and at 3-month follow-up. Likewise, there were slight improvements in fatigue, emotional functioning, and financial difficulties for APBI-treated patients at both of those time points.

In previous trials, APBI using external radiation beam techniques has likewise shown favorable and promising quality of life outcomes.

There are now eagerly anticipated studies of APBI delivered primarily using external beam techniques that have included rigorous collection of quality of life outcomes, Dr. Jagsi added.

Those trials, which include RAPID and RTOG 0413/NSABP B39, will provide additional evidence to consider alongside those of the trial reported by Schäfer and colleagues on behalf of the Groupe Européen de Curiethérapie of European Society for Radiotherapy and Oncology (GEC-ESTRO).

“Together with the results from the GEC-ESTRO trial, results from these trials will be meaningful to the many tens of thousands of women who undergo breast-conserving surgery and adjuvant radiotherapy each year,” Dr. Jagsi wrote.

Reshma Jagsi, MD, is with the department of radiation oncology at the University of Michigan, Ann Arbor. These comments are derived from editorial in Lancet Oncology . Dr. Jagsi reported receiving personal fees from Amgen.


 

FROM LANCET ONCOLOGY

In women with breast cancer undergoing breast-conserving surgery, accelerated partial breast irradiation (APBI) using multicatheter brachytherapy does not negatively affect quality of life, compared with standard whole breast irradiation, investigators have reported.

Patients reported similar quality of life scores for multicatheter brachytherapy–based APBI and whole breast irradiation in the study by the Groupe Européen de Curiethérapie of European Society for Radiotherapy and Oncology (GEC-ESTRO).

Moreover, breast symptom scores were significantly worse for whole-breast radiation, Rebekka Schäfer, MD, of the department of radiation oncology at the University Hospital Würzburg (Germany) and colleagues reported in Lancet Oncology.

“This trial provides further clinical evidence that APBI with interstitial brachytherapy can be considered as an alternative treatment option after breast-conserving surgery for patients with low-risk breast cancer,” Dr. Schäfer and coauthors wrote.

In several previous studies, APBI has been shown to have clinical outcomes equivalent to those of whole breast irradiation in terms of disease recurrence, survival, and treatment side effects, they added.

The quality of life findings in the present report come from long-term follow-up of a randomized, controlled, phase 3 trial conducted at 16 European centers. This study included 1,184 women with early breast cancer randomly who, after receiving breast-conserving surgery, were assigned either to APBI that used multicatheter brachytherapy or to whole breast irradiation.

Women in the study completed validated quality of life questionnaires right before and right after radiotherapy, as well as during follow-up.

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