Nicolò Matteo Luca Battisti
Observational cohort study in older women with early breast cancer: Use of radiation therapy and impact on health-related quality of life and mortality
Battisti, Nicolò Matteo Luca; Hatton, Matthew Q.; Reed, Malcolm W.R.; Herbert, Esther; Morgan, Jenna L.; Bradburn, Michael; Simcock, Richard; Walters, Stephen J.; Collins, Karen A.; Ward, Sue E.; Holmes, Geoffrey R.; Burton, Maria; Lifford, Kate J.; Edwards, Adrian; Robinson, Thompson G.; Martin, Charlene; Chater, Tim; Pemberton, Kirsty J.; Brennan, Alan; Leung Cheung, Kwok; Todd, Annaliza; Audisio, Riccardo A.; Wright, Juliet; Green, Tracy; Revell, Deirdre; Gath, Jacqui; Horgan, Kieran; Holcombe, Chris; Winter, Matthew C.; Naik, Jay; Parmeshwar, Rishi; Gosney, Margot A.; Thompson, Alastair M.; Wyld, Lynda; Ring, Alistair
Authors
Matthew Q. Hatton
Malcolm W.R. Reed
Esther Herbert
Jenna L. Morgan
Michael Bradburn
Richard Simcock
Stephen J. Walters
Karen A. Collins
Sue E. Ward
Geoffrey R. Holmes
Maria Burton
Kate J. Lifford
Adrian Edwards
Thompson G. Robinson
Charlene Martin
Tim Chater
Kirsty J. Pemberton
Alan Brennan
Professor KWOK_LEUNG CHEUNG KWOK_LEUNG.CHEUNG@NOTTINGHAM.AC.UK
Deputy Head of Education & Director of The Bmbs Medicine Programmes
Annaliza Todd
Riccardo A. Audisio
Juliet Wright
Tracy Green
Deirdre Revell
Jacqui Gath
Kieran Horgan
Chris Holcombe
Matthew C. Winter
Jay Naik
Rishi Parmeshwar
Margot A. Gosney
Alastair M. Thompson
Lynda Wyld
Alistair Ring
Abstract
Background: Radiotherapy reduces in-breast recurrence risk in early breast cancer (EBC) in older women. This benefit may be small and should be balanced against treatment effect and holistic patient assessment. This study described treatment patterns according to fitness and impact on health-related quality-of-life (HRQoL). Methods: A multicentre, observational study of EBC patients aged ≥ 70 years, undergoing breast-conserving surgery (BCS) or mastectomy, was undertaken. Associations between radiotherapy use, surgery, clinico-pathological parameters, fitness based on geriatric parameters and treatment centre were determined. HRQoL was measured using the European Organisation for the Research and Treatment of Cancer (EORTC) questionnaires. Results: In 2013–2018 2811 women in 56 UK study centres underwent surgery with a median follow-up of 52 months. On multivariable analysis, age and tumour risk predicted radiotherapy use. Among healthier patients (based on geriatric assessments) with high-risk tumours, 534/613 (87.1%) having BCS and 185/341 (54.2%) having mastectomy received radiotherapy. In less fit individuals with low-risk tumours undergoing BCS, 149/207 (72.0%) received radiotherapy. Radiotherapy effects on HRQoL domains, including breast symptoms and fatigue were seen, resolving by 18 months. Conclusion: Radiotherapy use in EBC patients ≥ 70 years is affected by age and recurrence risk, whereas geriatric parameters have limited impact regardless of type of surgery. There was geographical variation in treatment, with some fit older women with high-risk tumours not receiving radiotherapy, and some older, low-risk, EBC patients receiving radiotherapy after BCS despite evidence of limited benefit. The impact on HRQoL is transient.
Journal Article Type | Article |
---|---|
Acceptance Date | Jun 9, 2021 |
Online Publication Date | Jun 16, 2021 |
Publication Date | 2021-08 |
Deposit Date | Jun 28, 2021 |
Publicly Available Date | Jun 17, 2022 |
Journal | Radiotherapy and Oncology |
Print ISSN | 0167-8140 |
Electronic ISSN | 1879-0887 |
Publisher | Elsevier BV |
Peer Reviewed | Peer Reviewed |
Volume | 161 |
Pages | 166-176 |
DOI | https://doi.org/10.1016/j.radonc.2021.06.021 |
Keywords | Oncology; Radiology Nuclear Medicine and imaging; Hematology |
Public URL | https://nottingham-repository.worktribe.com/output/5745444 |
Publisher URL | https://www.thegreenjournal.com/article/S0167-8140(21)06593-2/fulltext |
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