Corica, T;
Nowak, AK;
Saunders, CM;
Bulsara, M;
Taylor, M;
Vaidya, JS;
Baum, M;
(2016)
Cosmesis and breast-related quality of life outcomes following intra-operative radiotherapy for early breast cancer - a sub-study of the TARGIT - a trial.
International Journal of Radiation Oncology *Biology *Physics
10.1016/j.ijrobp.2016.04.024.
(In press).
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12 Better Quality of life with TARGIT-IORT.pdf - Accepted Version Download (2MB) | Preview |
Abstract
Purpose: The international randomized TARGIT-A trial compared risk-adapted single-dose intra-operative radiotherapy (TARGIT-IORT) to 3-7 weeks of daily conventional external beam radiotherapy (EBRT) in women with early breast cancer treatable with breast conserving surgery. TARGIT-A showed TARGIT-IORT to be non-inferior compared to EBRT in terms of reducing the risk of local cancer recurrence and found no difference in breast cancer survival however its effect on patient reported cosmesis and breast-related quality of life (QOL) have not yet been described. Methods and Materials: Longitudinal cosmesis and QOL data were collected from a sub-set of TARGIT-A participants who received TARGIT-IORT as a separate procedure (post-pathology). Patients completed a cosmetic assessment before radiotherapy and annually thereafter for at least five years. Patients also completed the combined EORTC core questionnaire (QLQ-C30) and Breast Specific Module (BR23) in addition to the Body Image after Breast Cancer Questionnaire (BIABC) at baseline and annually thereafter. The combined EORTC questionnaires were also collected 3, 6, and 9 months after wide local excision (WLE). Results: An Excellent-Good (EG) cosmetic result was scored more often than a Fair-Poor (FP) result for both treatment groups across all time points. TARGIT-IORT patients reported better breast-related QOL than EBRT patients. Statistically and clinically significant differences were seen at month-6 and Year-1, with EBRT patients having moderately worse breast symptoms (a statistically significant difference of more than 10 in a 100 point scale) than TARGIT-IORT patients at these time points. Conclusion: Patients treated with TARGIT-IORT on the TARGIT-A trial have similar self-reported cosmetic outcome but better breast-related QOL outcomes than patients treated with EBRT. This important evidence can facilitate the treatment decision making process for patients who have early breast cancer suitable for breast conserving surgery and inform their clinicians.
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