High body mass index is associated with worse quality of life in breast cancer patients receiving radiotherapy.
The purpose of this study was to examine the impact of body mass index (BMI) on breast cancer patients' self-reported health-related quality of life among patients treated with radiation therapy (RT). Women with breast cancer undergoing RT were prospectively enrolled in an Institutional Review Board-approved clinical trial between 2009 and 2012. Quality of life (QOL) assessments were collected pre-RT, during RT, and within 3 months post-RT using Euroqol (EQ-5D), MD Anderson Symptom Inventory, and functional assessment of cancer therapy-general (FACT-G). 183 breast cancer patients were enrolled, of whom 140 completed assessments at one or more time-point. After adjusting for age, chemotherapy, prior RT, type of breast surgery, and comorbidities, higher BMI remained significantly associated with worse QOL pre-RT, during RT, and post-RT in breast cancer patients. Higher BMI was strongly associated with worse overall FACT-G score on treatment and greater decline in physical well-being on treatment, which persisted after treatment. While effects on QOL of patients in the underweight and normal weight group peaked during treatment, rapidly improving by follow-up, obese patients had worse functional well-being that was more persistent at follow-up. Higher BMI was associated with worse QOL for breast cancer patients before, during, and after RT, and also was associated with reduced return to baseline QOL 3 months post-RT.
Department of Radiation Oncology, Perelman School of Medicine of the University of Pennsylvania, PCAM/TRC 4 West, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA.
Penny
P
Fang
Kay See
KS
Tan
Andrea B
AB
Troxel
Ramesh
R
Rengan
Gary
G
Freedman
Lilie L
LL
Lin
D000203:Activities of Daily Living; D000328:Adult; D000339:Affect; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000523:psychology; D003131:Combined Modality Therapy; D015897:Comorbidity; D004417:Dyspnea / Q000453:epidemiology; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006801:Humans; D008569:Memory Disorders / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000523:psychology*; D010146:Pain / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000523:psychology; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013851:Thinness / Q000453:epidemiology / Q000523:psychology