Post-Surgery Accelerated Partial Breast Irradiation vs Whole-Breast Irradiation: QoL Outcomes

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A previous analysis showed that APBI had non-inferior efficacy.
A previous analysis showed that APBI had non-inferior efficacy.

Accelerated partial breast irradiation (APBI) with multicatheter brachytherapy does not affect long-term quality of life (QoL) compared with whole-breast irradiation among patients with breast cancer who undergo breast-conserving surgery, according to a study published in The Lancet Oncology.1

For the phase 3 GEC-ESTRO study (ClinicalTrials.gov identifier: NCT00402519), investigators randomly assigned 1184 patients with early-stage breast cancer who underwent breast-conserving surgery to receive whole-breast irradiation or APBI using multicatheter brachytherapy. A previous analysis showed that APBI had non-inferior efficacy.

Patients completed the European Organisation for Research and Treatment of Cancer QLQ-C30 and breast cancer module QLQ-BR23 — 2 QoL questionnaires — before radiotherapy, immediately after radiotherapy, and during follow-up.

Overall, 633 patients underwent APBI and 551 patients received whole-breast irradiation. Fifty-three percent vs 57% of patients in the APBI group vs whole-breast irradiation group completed the QoL questionnaires before radiotherapy, respectively. Follow-up response rates were similar.

Global health status remained stable and did not differ significantly between the 2 groups. The APBI group had a mean global health status score of 65.5 and 66.2 before radiotherapy and after 5-years, respectively, while patients in the whole-breast irradiation group had mean scores of 64.6 and 66.

Patients undergoing whole-breast irradiation, however, reported significantly worse breast symptom scores immediately following radiotherapy (P < .0001) and after 3-month follow-up (P < .0001).

The authors concluded that this 5-year follow-up evidence “supports APBI as an alternative treatment option after breast-conserving surgery for patients with early breast cancer.”

Reference

  1. Schafer R, Strnad V, Polgar C, et al. Quality-of-life results for accelerated partial breast irradiation with interstitial brachytherapy versus whole-breast irradiation in early breast cancer after breast-conserving surgery (GEC-ESTRO): 5-year results of a randomised, phase 3 trial. Lancet Oncol. 2018 Apr 22. doi: 10.1016/S1470-2045(18)30195-5

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