A Prospective Analysis of Quality of Life and Toxicity Outcomes in Treating Early Breast Cancer With Breast Conservation Therapy and Intraoperative Radiation Therapy

• Authors: Michael Sosin, Medstar Georgetown University Hospital; Surupa Sen Gupta, Medstar Georgetown University Hospital; Jessica S. Wang, Medstar Georgetown University Hospital; Corinne D. Costellic, Medstar Georgetown University Hospital; Aiste Gulla, Medstar Georgetown University Hospital; Alex J. Bartholomew, Medstar Georgetown University Hospital; Suzanne C. O'Neill, Georgetown Lombardi Comprehensive Cancer Center; Elizabeth Hechenbleikner, Emory University; Brian T. Collins, Medstar Georgetown University Hospital; Sonali Rudra, Medstar Georgetown University Hospital; Sean P. Collins, Medstar Georgetown University Hospital; Krysta M. Chaldekas, Georgetown Lombardi Comprehensive Cancer Center; Sulakshana Seevaratnam, Medstar Georgetown University Hospital; Russell C. Langan, Medstar Georgetown University Hospital; Shawna C. Willey, Medstar Georgetown University Hospital; Eleni A. Tousimis, Medstar Georgetown University Hospital
• Journal Title: FRONTIERS IN ONCOLOGY
• Volume: Volume 8, Number DEC
• Publisher: FRONTIERS MEDIA SA | 2018-12-03, Pages 545-545
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.3389/fonc.2018.00545
• Subjects: Health Sciences, Oncology; Biology, Radiation; Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Oncology; quality of life; radiation; intraoperative radiation; toxicity; breast conservation; RANDOMIZED-TRIAL; RADIOTHERAPY; IRRADIATION; MASTECTOMY; WOMEN; CARCINOMA; ELIOT

Abstract

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 1-week, 1-month, and subsequent 6-month intervals for 2 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 2-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.