title: A prospective longitudinal clinical trial evaluating quality of life after breast-conserving surgery and high-dose-rate interstitial brachytherapy for early-stage breast cancer.
abstract: OBJECTIVE
  To prospectively examine quality of life (QOL) of patients with early stage breast cancer treated with accelerated partial breast irradiation (APBI) using high-dose-rate (HDR) interstitial brachytherapy.
  
  
  METHODS
  Between March 2004 and December 2008, 151 patients with early stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients included those with Tis-T2 tumors measuring ≤3 cm excised with negative surgical margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. QOL was measured using European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, version 3.0, and QLQ-BR23 questionnaires. The QLQ-C30 and QLQ-BR23 questionnaires were evaluated during pretreatment and then at 6 to 8 weeks, 3 to 4 months, 6 to 8 months, and 1 and 2 years after treatment.
  
  
  RESULTS
  The median follow-up was 55 months. Breast symptom scores remained stable in the months after treatment, and they significantly improved 6 to 8 months after treatment. Scores for emotional functioning, social functioning, and future perspective showed significant improvement 2 years after treatment. Symptomatic fat necrosis was associated with several changes in QOL, including increased pain, breast symptoms, systemic treatment side effects, dyspnea, and fatigue, as well as decreased role functioning, emotional functioning, and social functioning.
  
  
  CONCLUSIONS
  HDR multicatheter interstitial brachytherapy was well tolerated, with no significant detrimental effect on measured QOL scales/items through 2 years of follow-up. Compared to pretreatment scores, there was improvement in breast symptoms, emotional functioning, social functioning, and future perspective 2 years after treatment.
authors.affiliation: Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Adam A
authors.initials: AA
authors.lastname: Garsa
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Ferraro
authors.forename: Todd A
authors.initials: TA
authors.lastname: DeWees
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Deshields
authors.forename: Julie A
authors.initials: JA
authors.lastname: Margenthaler
authors.forename: Amy E
authors.initials: AE
authors.lastname: Cyr
authors.forename: Michael
authors.initials: M
authors.lastname: Naughton
authors.forename: Rebecca
authors.initials: R
authors.lastname: Aft
authors.forename: William E
authors.initials: WE
authors.lastname: Gillanders
authors.forename: Timothy
authors.initials: T
authors.lastname: Eberlein
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Matesa
authors.forename: Laura L
authors.initials: LL
authors.lastname: Ochoa
authors.forename: Imran
authors.initials: I
authors.lastname: Zoberi
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy / Q000379:methods; D019583:Dose Fractionation, Radiation; D005218:Fat Necrosis / Q000150:complications / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D065026:Hope; D006801:Humans; D015412:Mastectomy, Segmental; D008603:Mental Health; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011788:Quality of Life; D011880:Radiotherapy Planning, Computer-Assisted; D058992:Social Participation; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires