Accelerated radiotherapy in patients over sixty years old after mastectomy: Acute and one-year physician-assessed toxicity and health-related quality of life

Article type: Research Article

Authors: Vakaet, Vincent^{a; b;} | Van Hulle, Hans^a; | Quataert, Viktor^a | Deseyne, Pieter^{a; b} | Schoepen, Max^{a; b; c} | Paelinck, Leen^b | Post, Giselle^a | Van Greveling, Annick^b | Speleers, Bruno^a | Mareel, Marc^a | De Neve, Wilfried^a | Monten, Chris^{a; b} | Veldeman, Liv^{a; b}

Affiliations: [a] Department of Human Structure and Repair, Ghent University, Ghent, Belgium | [b] Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium | [c] Department of Industrial Systems Engineering and Product Design, Kortrijk, Belgium

Correspondence: [*] Corresponding authors: Vincent Vakaet, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium. Tel.: +32 9 332 15 53; Fax: +32 9 332 30 40; E-mail: [email protected] and Hans Van Hulle, Department of Human Structure and Repair, Ghent University, Ghent, Belgium. E-mail: [email protected]

Abstract: INTRODUCTION:Postmastectomy radiotherapy reduces the risk of locoregional recurrence in breast cancer patients. The first results on accelerated radiotherapy in five fractions after breast conserving surgery are promising. The data on postmastectomy radiotherapy in five or six fractions is limited. We now present the data on acute and one-year toxicity and health related quality of life (HRQoL) after postmastectomy radiotherapy in patients of sixty years or older. METHODOLOGY:119 patients received five fractions of 5.7 Gy to the chest wall and five fractions of 5.4 Gy to the lymph nodes over ten to twelve days. Physician-assessed toxicity were scored using the Common Terminology Criteria for Adverse Events version 4.03 toxicity scoring system and the LENT-SOMA scale. Fatigue was measured by the Multidimensional Fatigue Inventory (MFI-206). HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire the breast cancer specific module and the BREAST-Q questionnaire. RESULTS:Fatigue and edema were the most frequently observed physician-assessed toxicities. One year after radiotherapy only 12.9% experienced a clinically important deterioration in chest wall symptoms and in 22.9% of the patients were improved. Future perspective at one year after radiotherapy was improved in 40.0% of the patients. Patient-reported fatigue showed the greatest improvement. CONCLUSION:Accelerated radiotherapy should be considered to minimize the burden of breast cancer treatment, especially in older patients.

Keywords: Radiation oncology, radiation side effects, radiation therapy techniques

DOI: 10.3233/BD-210080

Journal: Breast Disease, vol. 41, no. 1, pp. 261-266, 2022