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Factors Affecting Breast Cancer Patient Quality of Life in Association With Radiation

      Purpose/Objective(s)

      The goal of this study was to better characterize which factors have a significant impact on patients' health related quality of life (HRQOL) during radiation therapy for breast cancer.

      Materials/Methods

      Women with breast cancer were enrolled on a prospective clinical study approved by the hospital Institutional Review Board. QOL assessments were collected pre-RT, during RT, and within 3 months post-RT using EuroQOL (EQ-5D) and Functional Assessment of Cancer Therapy-General (FACT-G). Multiple linear regressions were used to assess for associations between each set of predictors and QOL measures. The predictors included for pre-RT surveys were continuous age, pre-RT chemotherapy, surgery type, previous RT, number of nodes removed, number of nodes involved, and BMI at baseline. For on-treatment survey, nodal RT and whole breast dose were added. RT duration was added for post-RT analyses.

      Results

      One hundred forty-one patients made up the study population. Median age of patients was 59 (30-77). The median BMI was 28.37 (17.57-45.59). Seventy-six patients had chemotherapy prior to RT. Thirty-two patients had a mastectomy and 109 patients had lumpectomy. Thirteen patients had previous RT. There were a median of 4 nodes removed (0-35) and a median of 0 nodes involved (0-23). The median whole breast dose was 46 Gy (34-54). Fifty-three patients had regional nodal radiation. The median treatment duration was 43 days (5-64). EQ visual analogue scale (EQ-VAS) had a significant decrease in the on-treatment survey when patients were treated with chemotherapy prior to RT (p = 0.0254). EQ-VAS had a significant decrease when patients had longer treatment duration reflected in the post-RT survey (p = 0.0183). Significant FACT-G associations in the overall and individual subsections of physical well-being (PWB), emotional well-being (EWB) and functional well-being (FWB) are shown in Table. Pre-RT chemotherapy, higher BMI, mastectomy, increase in nodes removed, and increased RT duration were linked to significantly decreased QOL when significant. Prior RT and higher number of nodes involved were linked to increased QOL when significant. FACT-G social well-being (SWB) and FACT-G total post-treatment had no factors that reached significance.

      Conclusions

      Factors significantly affecting QOL in association with RT for breast cancer include pre-RT chemotherapy, treatment duration, BMI, type of surgery, number of nodes removed and involved, and prior RT.
      Oral Scientific Abstract 283; TableSignificant FACT-G associations with different treatment factors
      Total PreTotal OnPWB PrePWB OnPWB PostEWB PostFWB PreFWB OnFWB Post
      Chemotherapy (Yes)0.00640.00030.02590.0010
      BMI0.01690.00150.01340.0022
      Surgery (Mastectomy)0.02520.0213
      Nodes removed0.0159
      Nodes involved0.0401
      Prior RT0.0300
      Treatment duration0.0422

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