Annals of Surgical Oncology

, Volume 17, Supplement 3, pp 359–367

Health-Related Quality of Life After Breast-Conserving Surgery and Intraoperative Radiotherapy for Breast Cancer Using Low-Kilovoltage X-rays

  • Grit Welzel
  • Frank Hofmann
  • Elena Blank
  • Uta Kraus-Tiefenbacher
  • Brigitte Hermann
  • Marc Sütterlin
  • Frederik Wenz
American Society of Breast Surgeons

DOI: 10.1245/s10434-010-1257-z

Cite this article as:
Welzel, G., Hofmann, F., Blank, E. et al. Ann Surg Oncol (2010) 17(Suppl 3): 359. doi:10.1245/s10434-010-1257-z

Abstract

Background

Intraoperative radiotherapy (IORT) is currently being evaluated as a novel approach during breast-conserving surgery (BCS). IORT can be used either as a tumor bed boost followed by external-beam radiotherapy (EBRT) or as a single treatment. In a matched-pair study, we assessed quality of life (QoL) in 69 patients with early breast cancer treated with BCS and/or IORT and/or EBRT.

Methods

Patients were matched for age and time since BCS. IORT was provided with 50 kV x-rays (Intrabeam) delivering 20 Gy at the applicator surface. EBRT (46 to 50 Gy in 2-Gy fractions in the IORT with EBRT group, and 56 Gy in 2-Gy fractions in the EBRT group) was initiated after completion of wound healing and/or chemotherapy. The mailed questionnaires included the European Organization for the Research and Treatment of Cancer QLQ-C30 and BR23, FACT-F, HADS, Body Image Scale, and Rosenberg Self-Esteem Scale. At 18 to 70 months’ follow-up (median 47 months), all patients were disease free.

Results

We found only a few differences between the three groups. There was a trend toward more pain (mean ± standard deviation; 42.8 ± 32.9 vs. 27.5 ± 34.7) and reduced QoL (57.6 ± 20.7 vs. 70.3 ± 23.9) after IORT with EBRT compared with EBRT, respectively. IORT patients reported comparable QoL (70.3 ± 23.0), and less breast symptoms and body image concerns compared to EBRT (8.6 ± 12.3 vs. 19.2 ± 23.8, and 1.7 ± 3.3 vs. 3.4 ± 4.4, respectively). IORT alone resulted in significantly fewer breast symptoms (8.6 ± 12.3; P = 0.012) and less pain (23.9 ± 24.5, P = 0.041) compared with IORT with EBRT (26.1 ± 27.6; 42.8 ± 32.9, respectively).

Conclusions

Patients with early breast cancer after BCS and IORT with or without EBRT present with comparable QoL like patients receiving EBRT without a boost. IORT patients show the lowest rate of breast symptoms.

Copyright information

© Society of Surgical Oncology 2010

Authors and Affiliations

  • Grit Welzel
    • 1
  • Frank Hofmann
    • 1
  • Elena Blank
    • 1
  • Uta Kraus-Tiefenbacher
    • 1
  • Brigitte Hermann
    • 1
  • Marc Sütterlin
    • 2
  • Frederik Wenz
    • 1
  1. 1.Department of Radiation Oncology, University Medical Center MannheimUniversity of HeidelbergMannheimGermany
  2. 2.Department of Obstetrics and Gynecology, University Medical Center MannheimUniversity of HeidelbergMannheimGermany