Quality of life in breast cancer patients over the age of 65 years after organ-sparing treatment with or without radiation therapy

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To study the impact of radiation therapy (RT) after organ-sparing surgery (OSS) for breast cancer (BC) on quality of life (QoL) in patients over the age of 65 years.

Subjects and methods. The investigation enrolled 133 patients with Stage IA BC who underwent OSS. The patients were divided into 2 groups: 1) patients who had received RT after surgical treatment; 2) those who had not. All the patients included in the investigation received adjuvant hormone therapy for ≥5 years. The mean follow-up period was 61.77±20.10 months. QoL was comparatively assessed using the EORTC QLQ-C30 Version 3 and EORTC QLQ-BR23 questionnaires.

Results. The scores on functional and symptom scales and those on the EORTC QLQ-C30 V.3 Global health status/QoL were statistically comparable in the examined groups (p > 0.05). Statistically significant differences between the groups were obtained in assessing the EORTC QLQ-BR23 Body image (BRBI). Arm symptoms (BRAS), and Breast symptoms (BRBS) (p<0.05). At the same time, lower scores were obtained in the RT group. No significant differences were found in the EORTC QLQ-BR23 future perspective (BRFU) and Systemic therapy side effects (BRST) (p>0.05).

Conclusion. After CCA with and without RT, the patients older than 65 years showed no significant differences in the assessment of QoL using the Global health status/QoL symptom, functional, and BRFU scales. QoL assessment using BRBI, BRBS, and BRAS demonstrated lower scores in the RT group. Thus, it may be concluded that RT does not worsen the overall QoL in patients, whereas it exerts local side effects in the area of irradiated tissues.

Full Text

Restricted Access

About the authors

D. Ortabaeva

P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia

Author for correspondence.
Email: rasskaz2@yandex.ru
Russian Federation, Moscow

A. Zikiryakhodzhaev

P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia; Peoples’ Friendship University of Russia

Email: rasskaz2@yandex.ru

MD

Russian Federation, Moscow; Moscow; Moscow

E. Rasskazova

P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia

Email: rasskaz2@yandex.ru

Candidate of Medical Sciences

Russian Federation, Moscow

V. Tokaev

P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia

Email: rasskaz2@yandex.ru
Russian Federation, Moscow

E. Khmelevsky

P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia

Email: rasskaz2@yandex.ru

MD

Russian Federation, Moscow

References

  1. Ortabaeva D.R., Zikiryakhodzhayev A.D., Rasskazova E.A. et al. Treatment option for Stage 1 breast cancer in patients over 65 years of age. P.A. Herzen Journal of Oncology. 2021; 10 (5): 55–60 (in Russ.). doi: 10.17116/onkolog20211005155
  2. International Agency for Research on Cancer, Press Release №263. Available at: https://www.iarc.fr/wpcontent/uploads/2018/09/pr263_E.pdf
  3. World Health Organization (2016) Definition of an older or elderly person. Available at: https://www.who.int/ healthinfo/survey/ageingdefnolder/en/
  4. Biganzoli L., Goldhirsch A., Straehle C. et al. Adjuvant chemotherapy in elderly patients with breast cancer: a survey of the Breast International Group (BIG). Ann Oncol. 2004; 15 (2): 207–10. doi: 10.1093/annonc/mdh062
  5. Estimated Number of New Cases for the Four Major Cancers by Sex and Age Group, 2019. American Cancer Organization. Available at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2019/estimated-new-cases-for-the-four-major-cancers-by-sex-and-age-group-2019.pdf
  6. Muss H.B. Coming of Age: Breast Cancer in Seniors. Oncologist. 2011; 16 (S1): 79–87. doi: 10.1634/theoncologist.2011-S1-79
  7. Hutchins L.F., Unger J.M., Crowley J.J. et al. Underrepresentation of patients 65 years of age or older in cancer-treatment trials. N Engl J Med. 1999; 341 (27): 2061–7. doi: 10.1056/NEJM199912303412706
  8. Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomized trials. Lancet. 2005; 365 (9472): 1687–717. doi: 10.1016/S0140-6736(05)66544-0
  9. Kunkler I.H., Williams L.J., Jack W.J. et al. Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomized controlled trial. Lancet Oncol. 2015; 16 (3): 266–73. doi: 10.1016/S1470-2045(14)71221-5
  10. Crivellari D., Sun Z., Coates A.S. et al. Letrozole compared with tamoxifen for elderly patients with endocrineresponsive early breast cancer: the BIG 1-98 trial. J Clin Oncol. 2008; 26 (12): 1972–9. doi: 10.1200/JCO.2007.14.0459
  11. Muss H.B., Berry D.A., Cirrincione C.T. et al. Adjuvant chemotherapy in older women with early-stage breast cancer. N Engl J Med. 2009; 360 (20): 2055–65. doi: 10.1056/NEJMoa0810266
  12. Untch M., Gelber R.D., Jackisch C. et al. Estimating the magnitude of trastuzumab effects within patient subgroups in the HERA trial. Ann Oncol. 2008; 19 (6): 1090–6. doi: 10.1093/annonc/mdn005
  13. Cabarrou B., Mourey L., Dalenc F. et al. Methodology of phase II clinical trials in metastatic elderly breast cancer: a literature review. Breast Cancer Res Treat. 2017; 164 (3): 505–13. doi: 10.1007/s10549-017-4278-5
  14. Diab S.G., Elledge R.M., Clark G.M. Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst. 2000; 92 (7): 550–6. doi: 10.1093/jnci/92.7.550
  15. Gosain R., Pollock Y., Jain D. Age-related disparity: Breast Cancer in the elderly. Curr Oncol Rep. 2016; 18 (11): 69. doi: 10.1007/s11912-016-0551-8
  16. Clarke M., Collins R., Darby S. et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomized trials. Lancet. 2005; 366 (9503): 2087–106. doi: 10.1016/S0140-6736(05)67887-7
  17. Hughes K.S., Schnaper L.A., Berry D. et al. Lumpectomy plus tamoxifen with or without irradiation in women aged 70 or older with early breast cancer. N Engl J Med. 2004; 351 (10): 971–7. doi: 10.1056/NEJMoa040587
  18. Hughes K.S., Schnaper L.A., Bellon J.R. et al. Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343. J Clin Oncol. 2013; 31 (19): 2382–7. doi: 10.1200/JCO.2012.45.2615
  19. Prescott R.J., Kunkler I.H., Williams L.J. et al. A randomized controlled trial of postoperative radiotherapy following breastconserving surgery in a minimum-risk older population. The PRIME trial. Health Technol Assess. 2007; 11 (31): 1–149, iii–iv. doi: 10.3310/hta11310
  20. Williams L.J., Kunkler I.H., King C.C. et al. A randomized controlled trial of post-operative radiotherapy following breast-conserving surgery in a minimum-risk population. Quality of life at 5 years in the PRIME trial. Health Technol Assess. 2011; 15 (12): i–xi, 1–57. doi: 10.3310/hta15120

Supplementary files

Supplementary Files
Action
1. JATS XML

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies