Health-related quality of life in survivors of stage I-II breast cancer: randomized trial of post-operative conventional radiotherapy and hypofractionated tomotherapy.
Health-related quality of life in survivors of stage I-II breast cancer: randomized trial of post-operative conventional radiotherapy and hypofractionated tomotherapy.
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DOI：
10.1186/1471-2407-12-495
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发表时间：
2012-10-25
期刊：
影响因子：
3.8
通讯作者：
De Ridder M
中科院分区：
文献类型：
--
作者：
Versmessen H;Vinh-Hung V;Van Parijs H;Miedema G;Voordeckers M;Adriaenssens N;Storme G;De Ridder M
健康相关生活质量（HRQOL）评估是临床肿瘤学试验的关键组成部分。然而，很少有比较辅助常规放疗（CR）和大分割断层放疗（TT）的乳腺癌试验研究HRQOL。我们比较了随机接受CR或TT治疗的I-II期乳腺癌患者的HRQOL。断层治疗使用集成的计算机断层扫描仪来提高治疗精度，旨在减少放射治疗的不良反应。共121例接受保乳手术（BCS）或乳房切除术（MA）的I-II期乳腺癌患者被随机分配接受CR或TT。CR患者接受25 × 2戈伊5周，BCS患者也接受8 × 2戈伊2周的序贯加强治疗。TT患者在3周内接受15 × 2.8戈伊，BCS患者也在3周内同时接受15 × 0.6戈伊的综合加强治疗。患者完成EORTC QLQ-C30和BR 23问卷。计算基线、放疗结束、放疗后3个月、1年、2年和3年的平均评分（±标准误）。数据分析采用“意向治疗”原则。在放疗的最后一天，两个治疗组的患者总体健康状况和功能评分下降;疲乏（两个治疗组均具有临床意义）、恶心和呕吐以及便秘增加;手臂症状减少; CR患者的乳房症状和TT患者的全身副作用增加具有临床意义;身体形象和未来展望轻微下降。在放疗后3个月，TT患者的角色和社会功能评分有临床意义的增加，疲劳有临床意义的减少。放疗后TT患者的身体、认知和情感功能评分比CR患者改善更快。TT患者也比CR患者有更好的长期疲劳恢复。Bonferroni校正的ANOVA未显示组间HRQOL评分的任何显著差异。与CR患者相比，TT患者在整体健康状况和角色及认知功能方面有更好的改善，并且从疲劳中恢复得更快。这些结果表明，较短的分割时间表可能会减少治疗的不良反应。
Health-related quality of life (HRQOL) assessment is a key component of clinical oncology trials. However, few breast cancer trials comparing adjuvant conventional radiotherapy (CR) and hypofractionated tomotherapy (TT) have investigated HRQOL. We compared HRQOL in stage I-II breast cancer patients who were randomized to receive either CR or TT. Tomotherapy uses an integrated computed tomography scanner to improve treatment accuracy, aiming to reduce the adverse effects of radiotherapy. A total of 121 stage I–II breast cancer patients who had undergone breast conserving surgery (BCS) or mastectomy (MA) were randomly assigned to receive either CR or TT. CR patients received 25 × 2 Gy over 5 weeks, and BCS patients also received a sequential boost of 8 × 2 Gy over 2 weeks. TT patients received 15 × 2.8 Gy over 3 weeks, and BCS patients also received a simultaneous integrated boost of 15 × 0.6 Gy over 3 weeks. Patients completed the EORTC QLQ-C30 and BR23 questionnaires. The mean score (± standard error) was calculated at baseline, the end of radiotherapy, and at 3 months and 1, 2, and 3 years post-radiotherapy. Data were analyzed by the 'intention-to-treat' principle. On the last day of radiotherapy, patients in both treatment arms had decreased global health status and functioning scores; increased fatigue (clinically meaningful in both treatment arms), nausea and vomiting, and constipation; decreased arm symptoms; clinically meaningful increased breast symptoms in CR patients and systemic side effects in TT patients; and slightly decreased body image and future perspective. At 3 months post-radiotherapy, TT patients had a clinically significant increase in role- and social-functioning scores and a clinically significant decrease in fatigue. The post-radiotherapy physical-, cognitive- and emotional-functioning scores improved faster in TT patients than CR patients. TT patients also had a better long-term recovery from fatigue than CR patients. ANOVA with the Bonferroni correction did not show any significant differences between groups in HRQOL scores. TT patients had a better improvement in global health status and role- and cognitive-functioning, and a faster recovery from fatigue, than CR patients. These results suggest that a shorter fractionation schedule may reduce the adverse effects of treatment.
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影响因子：
2.7
作者：
EFRON, B
通讯作者：
EFRON, B
影响因子：
10.3
作者：
Gebski, V;Lagleva, M;Langlands, AO
通讯作者：
Langlands, AO
DOI：
10.1007/s00432-003-0540-9
发表时间：
2004-06-01
影响因子：
3.6
作者：
Geinitz, H;Zimmermann, FB;Molls, M
通讯作者：
Molls, M
DOI：
10.1111/j.1440-1673.2005.01392.x
发表时间：
2005-02-01
期刊：
Australasian radiology
影响因子：
--
作者：
Back, M;Ahern, V;Wratten, C
通讯作者：
Wratten, C
影响因子：
4.9
作者：
Osoba, David
通讯作者：
Osoba, David