Longitudinal analysis of patient-reported outcomes and cosmesis in a randomized trial of conventionally fractionated versus hypofractionated whole-breast irradiation

被引:32
|
作者
Swanick, Cameron W. [1 ]
Lei, Xiudong [2 ]
Shaitelman, Simona F. [1 ]
Schlembach, Pamela J. [1 ]
Bloom, Elizabeth S. [1 ]
Fingeret, Michelle C. [3 ]
Strom, Eric A. [1 ]
Tereffe, Welela [1 ]
Woodward, Wendy A. [1 ]
Stauder, Michael C. [1 ]
Dvorak, Tomas [4 ]
Thompson, Alastair M. [5 ]
Buchholz, Thomas A. [1 ]
Smith, Benjamin D. [1 ,2 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, 1515 Holcombe Blvd,Unit 1202, Houston, TX 77030 USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Hlth Serv Res, Houston, TX 77030 USA
[3] Univ Texas MD Anderson Canc Ctr, Dept Behav Sci, Houston, TX 77030 USA
[4] Univ Florida, Hlth Canc Ctr Orlando Hlth, Dept Radiat Oncol, Orlando, FL USA
[5] Univ Texas MD Anderson Canc Ctr, Dept Breast Surg Oncol, Houston, TX 77030 USA
基金
美国国家卫生研究院;
关键词
breast cancer; cosmesis; hypofractionation; patient-reported outcomes; whole-breast irradiation; QUALITY-OF-LIFE; RADIATION-THERAPY; CANCER; RADIOTHERAPY; LONG;
D O I
10.1002/cncr.30121
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUNDThe authors compared longitudinal patient-reported outcomes and physician-rated cosmesis with conventionally fractionated whole-breast irradiation (CF-WBI) versus hypofractionated whole-breast irradiation (HF-WBI) within the context of a randomized trial. METHODSFrom 2011 to 2014, a total of 287 women with American Joint Committee on Cancer stage 0 to stage II breast cancer were randomized to receive CF-WBI (at a dose of 50 grays in 25 fractions plus a tumor bed boost) or HF-WBI (at a dose of 42.56 grays in 16 fractions plus a tumor bed boost) after breast-conserving surgery. Patient-reported outcomes were assessed using the Breast Cancer Treatment Outcome Scale (BCTOS), the Functional Assessment of Cancer Therapy-Breast, and the Body Image Scale and were recorded at baseline and 0.5, 1, 2, and 3 years after radiotherapy. Physician-rated cosmesis was assessed at the same time points. Outcomes by treatment arm were compared at each time point using a 2-sided Student t test. Multivariable mixed effects growth curve models assessed the effects of treatment arm and time on longitudinal outcomes. RESULTSOf the 287 patients enrolled, 149 were randomized to CF-WBI and 138 were randomized to HF-WBI. At 2 years, the Functional Assessment of Cancer Therapy-Breast Trial Outcome Index score was found to be modestly better in the HF-WBI arm (mean 79.6 vs 75.9 for CF-WBI; P=.02). In multivariable mixed effects models, treatment arm was not found to be associated with longitudinal outcomes after adjusting for time and baseline outcome measures (P.14). The linear effect of time was significant for BCTOS measures of functional status (P=.001, improved with time) and breast pain (P=.002, improved with time). CONCLUSIONSIn this randomized trial, longitudinal outcomes did not appear to differ by treatment arm. Patient-reported functional and pain outcomes improved over time. These findings are relevant when counseling patients regarding decisions concerning radiotherapy. Cancer 2016. (c) 2016 American Cancer Society. Cancer 2016;122:2886-2894. (c) 2016 American Cancer Society
引用
收藏
页码:2886 / 2894
页数:9
相关论文
共 50 条
  • [1] Longitudinal Analysis of Patient-Reported Outcomes and Cosmesis in a Randomized Trial of Conventionally Fractionated Versus Hypofractionated Whole-Breast Irradiation
    Swanick, C. W.
    Lei, X.
    Shaitelman, S. F.
    Schlembach, P. J.
    Bloom, E. S.
    Fingeret, M.
    Strom, E. A.
    Tereffe, W.
    Woodward, W. A.
    Stauder, M. C.
    Dvorak, T.
    Buchholz, T. A.
    Smith, B. D.
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2016, 96 (02): : S6 - S6
  • [2] Five-Year Longitudinal Analysis of Patient-Reported Outcomes and Cosmesis in a Randomized Trial of Conventionally Fractionated Versus Hypofractionated Whole-Breast Irradiation
    Weng, Julius K.
    Lei, Xiudong
    Schlembach, Pamela
    Bloom, Elizabeth S.
    Shaitelman, Simona F.
    Arzu, Isidora Y.
    Chronowski, Gregory
    Dvorak, Tomas
    Grade, Emily
    Hoffman, Karen
    Perkins, George
    Reed, Valerie K.
    Shah, Shalin J.
    Stauder, Michael C.
    Strom, Eric A.
    Tereffe, Welela
    Woodward, Wendy A.
    Hortobagyi, Gabriel N.
    Hunt, Kelly K.
    Buchholz, Thomas A.
    Smith, Benjamin D.
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2021, 111 (02): : 360 - 370
  • [3] 5-Year Longitudinal Analysis of Patient-Reported Outcomes and Cosmesis in a Randomized Trial of Conventionally Fractionated versus Hypofractionated Whole-Breast Irradiation
    Smith, Benjamin
    Weng, Julius
    Lei, Xiudong
    Schlembach, Pamela
    Bloom, Elizabeth
    Shaitelman, Simona
    Arzu, Isidora
    Buchholz, Daniel
    Chronowski, Gregory
    Dvorak, Tomas
    Grade, Emily
    Hoffman, Karen
    Perkins, George
    Reed, Valerie
    Shah, Shalin
    Stauder, Michael
    Strom, Eric
    Tereffe, Welela
    Woodward, Wendy
    Hortobagyi, Gabriel
    Hunt, Kelly
    Buchholz, Thomas
    [J]. AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS, 2021, 44 (10): : S17 - S18
  • [4] Three-Year Outcomes With Hypofractionated Versus Conventionally Fractionated Whole-Breast Irradiation: Results of a Randomized, Noninferiority Clinical Trial
    Shaitelman, Simona F.
    Lei, Xiudong
    Thompson, Alastair
    Schlembach, Pamela
    Bloom, Elizabeth S.
    Arzu, Isidora Y.
    Buchholz, Daniel
    Chronowski, Gregory
    Dvorak, Tomas
    Grade, Emily
    Hoffman, Karen
    Perkins, George
    Reed, Valerie K.
    Shah, Shalin J.
    Stauder, Michael C.
    Strom, Eric A.
    Tereffe, Welela
    Woodward, Wendy A.
    Amaya, Diana N.
    Shen, Yu
    Hortobagyi, Gabriel N.
    Hunt, Kelly K.
    Buchholz, Thomas A.
    Smith, Benjamin D.
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2018, 36 (35) : 3495 - +
  • [5] Patient preference study comparing hypofractionated versus conventionally fractionated whole-breast irradiation after breast-conserving surgery
    Kawaguchi, Hiroki
    Tsujino, Kayoko
    Miki, Mayuko
    Matsumoto, Yoko
    Ota, Yosuke
    Hirokaga, Koichi
    Takao, Shintaro
    Soejima, Toshinori
    Sasaki, Ryohei
    [J]. JAPANESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 49 (06) : 545 - 553
  • [6] Acute and Short-term Toxic Effects of Conventionally Fractionated vs Hypofractionated Whole-Breast Irradiation A Randomized Clinical Trial
    Shaitelman, Simona F.
    Schlembach, Pamela J.
    Arzu, Isidora
    Ballo, Matthew
    Bloom, Elizabeth S.
    Buchholz, Daniel
    Chronowski, GregoryM.
    Dvorak, Tomas
    Grade, Emily
    Hoffman, Karen E.
    Kelly, Patrick
    Ludwig, Michelle
    Perkins, George H.
    Reed, Valerie
    Shah, Shalin
    Stauder, Michael C.
    Strom, Eric A.
    Tereffe, Welela
    Woodward, Wendy A.
    Ensor, Joe
    Baumann, Donald
    Thompson, Alastair M.
    Amaya, Diana
    Davis, Tanisha
    Guerra, William
    Hamblin, Lois
    Hortobagyi, Gabriel
    Hunt, Kelly K.
    Buchholz, Thomas A.
    Smith, Benjamin D.
    [J]. JAMA ONCOLOGY, 2015, 1 (07) : 931 - 941
  • [7] Comparison between Hypofractionated and Conventionally Fractionated Whole-breast Irradiation in Early Breast Cancer Patients
    Karasawa, K.
    Hojo, H.
    Kunogi, H.
    Izawa, H.
    Hirowatari, H.
    Sasai, K.
    Kawashima, M.
    Furuya, T.
    Sugimoto, S.
    Ozawa, S.
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2011, 81 (02): : S94 - S95
  • [8] Patient Reported Outcomes and Cosmesis Following Once Weekly Hypofractionated Breast Irradiation
    Eldredge-Hindy, H. B.
    Dragun, A. E.
    Roberts, T.
    Ajkay, N.
    Riley, E.
    Mandadi, M.
    McMasters, K. M.
    Quillo, A.
    Scoggins, C.
    Ahmad, M.
    Woo, S. Y.
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2018, 102 (03): : E575 - E576
  • [9] Three-year outcomes with hypofractionated (HF) versus conventionally fractionated (CF) whole breast irradiation (WBI)
    Shaitelman, Simona F.
    Lei, Xiudong
    Thompson, Alastair
    Schlembach, Pamela
    Arzu, Isiora
    Bloom, Elizabeth S.
    Buchholz, Daniel J.
    Chronowski, Gregory M.
    Dvorak, Tomas
    Grade, Emily J.
    Hoffman, Karen E.
    Kelly, Patrick
    Perkins, George H.
    Reed, Valerie
    Shah, Shalin
    Stauder, Michael C.
    Strom, Eric A.
    Tereffe, Welela
    Woodward, Wendy A.
    Baumann, Donald
    Amaya, Diana
    Guerra, William
    Morrison, Matricia
    Hortobagyi, Gabriel
    Hunt, Kelly K.
    Buchholz, Thomas A.
    Smith, Benjamin D.
    [J]. CANCER RESEARCH, 2018, 78 (04)
  • [10] Dosimetric Predictors of Toxicity and Cosmesis in Women Treated With Hypofractionated Whole-Breast Irradiation
    Hymas, R. V.
    Jawad, M. S.
    Mangona, V. S.
    Zamdborg, L.
    Wobb, J. L.
    Pietron, A.
    Wallace, M.
    Chen, P. Y.
    Grills, I. S.
    Brabbins, D. S.
    Dilworth, J. T.
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2014, 90 : S270 - S271