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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.
A little more than half of the women in each group completed the quality of life questionnaires after the treatment and again at follow-up, investigators said.
Global health status was stable over time in both groups, investigators reported. In the APBI group, global health status score on a scale of 0-100 was 65.6 right after the procedure and 66.2 at 5 years; similarly, scores in the whole breast irradiation group were 64.6 after radiotherapy and 66.0 at 5 years.
The only quality of life difference between arms that investigators characterized as moderately clinically relevant was in breast symptom scores, which were significantly worse in the whole breast radiation group right after radiotherapy (difference of means, 13.6; 95% CI, 9.7-17.5; P less than .0001) and at 3-month follow-up (difference of means, 12.7; 95% CI, 9.8-15.6; P less than .0001).
Emotional functioning, fatigue, and financial difficulty scores in the APBI group were “slightly better” than in the whole breast radiation group right after radiotherapy and at a 3-month follow-up, investigators reported; however, at 5 year follow-up, there were no significant differences between arms in those measures.
“Our findings show that APBI using multicatheter interstitial brachytherapy does not result in clinically significant deterioration of overall quality of life and that the different domains of quality of life after APBI were not worse in comparison with whole breast irradiation in terms of clinically relevant differences,” Dr. Schäfer and colleagues concluded in their report.
Dr. Schäfer reported no conflicts of interest. Coauthors reported disclosures outside of the submitted work including Nucletron Operations BV, Elekta Company, Merck Serono, Novocure, AstraZeneca, and Bristol-Myers Squibb, among others.
SOURCE: Schäfer R et al. Lancet Oncol. 2018 Apr 22. doi: 10.1016/S1470-2045(18)30195-5.
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.
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.
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.
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.
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.
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.
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.
A little more than half of the women in each group completed the quality of life questionnaires after the treatment and again at follow-up, investigators said.
Global health status was stable over time in both groups, investigators reported. In the APBI group, global health status score on a scale of 0-100 was 65.6 right after the procedure and 66.2 at 5 years; similarly, scores in the whole breast irradiation group were 64.6 after radiotherapy and 66.0 at 5 years.
The only quality of life difference between arms that investigators characterized as moderately clinically relevant was in breast symptom scores, which were significantly worse in the whole breast radiation group right after radiotherapy (difference of means, 13.6; 95% CI, 9.7-17.5; P less than .0001) and at 3-month follow-up (difference of means, 12.7; 95% CI, 9.8-15.6; P less than .0001).
Emotional functioning, fatigue, and financial difficulty scores in the APBI group were “slightly better” than in the whole breast radiation group right after radiotherapy and at a 3-month follow-up, investigators reported; however, at 5 year follow-up, there were no significant differences between arms in those measures.
“Our findings show that APBI using multicatheter interstitial brachytherapy does not result in clinically significant deterioration of overall quality of life and that the different domains of quality of life after APBI were not worse in comparison with whole breast irradiation in terms of clinically relevant differences,” Dr. Schäfer and colleagues concluded in their report.
Dr. Schäfer reported no conflicts of interest. Coauthors reported disclosures outside of the submitted work including Nucletron Operations BV, Elekta Company, Merck Serono, Novocure, AstraZeneca, and Bristol-Myers Squibb, among others.
SOURCE: Schäfer R et al. Lancet Oncol. 2018 Apr 22. doi: 10.1016/S1470-2045(18)30195-5.
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.
A little more than half of the women in each group completed the quality of life questionnaires after the treatment and again at follow-up, investigators said.
Global health status was stable over time in both groups, investigators reported. In the APBI group, global health status score on a scale of 0-100 was 65.6 right after the procedure and 66.2 at 5 years; similarly, scores in the whole breast irradiation group were 64.6 after radiotherapy and 66.0 at 5 years.
The only quality of life difference between arms that investigators characterized as moderately clinically relevant was in breast symptom scores, which were significantly worse in the whole breast radiation group right after radiotherapy (difference of means, 13.6; 95% CI, 9.7-17.5; P less than .0001) and at 3-month follow-up (difference of means, 12.7; 95% CI, 9.8-15.6; P less than .0001).
Emotional functioning, fatigue, and financial difficulty scores in the APBI group were “slightly better” than in the whole breast radiation group right after radiotherapy and at a 3-month follow-up, investigators reported; however, at 5 year follow-up, there were no significant differences between arms in those measures.
“Our findings show that APBI using multicatheter interstitial brachytherapy does not result in clinically significant deterioration of overall quality of life and that the different domains of quality of life after APBI were not worse in comparison with whole breast irradiation in terms of clinically relevant differences,” Dr. Schäfer and colleagues concluded in their report.
Dr. Schäfer reported no conflicts of interest. Coauthors reported disclosures outside of the submitted work including Nucletron Operations BV, Elekta Company, Merck Serono, Novocure, AstraZeneca, and Bristol-Myers Squibb, among others.
SOURCE: Schäfer R et al. Lancet Oncol. 2018 Apr 22. doi: 10.1016/S1470-2045(18)30195-5.
FROM LANCET ONCOLOGY
Key clinical point: Quality of life results support the use of accelerated partial breast irradiation (APBI) using multicatheter brachytherapy as an alternative to whole breast radiation after breast-conserving surgery.
Major finding: Patients reported similar quality of life scores for the two modalities, while breast symptom scores for whole breast radiation were significantly worse right after radiotherapy (difference of means, 13.6; 95% confidence interval, 9.7-17.5; P less than .0001) and at 3-month follow-up (difference of means, 12.7; 95% CI, 9.8-15.6; P less than .0001), compared with those for APBI.
Study details: 5-year quality of life results from a European phase 3 trial including 1,184 women with early breast cancer who, after undergoing breast-conserving surgery, received either whole breast irradiation or APBI using multicatheter brachytherapy.
Disclosures: Authors reported disclosures outside of the submitted work including Nucletron Operations BV, Elekta Company, Merck Serono, Novocure, AstraZeneca, and Bristol-Myers Squibb, among others.
Source: Schäfer R et al. Lancet Oncol. 2018 Apr 22. doi: 10.1016/S1470-2045(18)30195-5.