Abstract
Goals of the work
In cancer patients, there is an ongoing interest in evaluating the impact of therapeutic interventions on health-related quality of life (hrqol). However, only a few longitudinal studies are published being able to measure the influence of therapy for the patients’ quality of life. Based on these data, our aim was to evaluate changes of hrqol during the course of adjuvant radiotherapy in breast cancer patients with special focus on subgroup analysis.
Materials and methods
Sixty-one women undergoing radiotherapy after breast conserving surgery were asked to answer the EORTC Quality of life questionnaire (EORTC-QOL-C30) three times: at the beginning of radiotherapy, in the forth week and 6 weeks after the end of treatment. To identify patients with changes of their qol during the observation time, the function scale “Global health status/Quality of life” was used enabling us to classify three subgroups: (1) unchanged hrqol (NC), (2) increasing hrqol (INC), (3) decreasing of hrqol (DEC).
Main results
Patients with an increasing hrqol (N = 25) demonstrated a significant increase in the role as well as in the emotional functioning scales. In patients with a decreasing hrqol (N = 15), no changes in any of the function scales were found, while a significant decrease in their cognitive functioning was observed in patients with no change in hrqol (N = 21).
Conclusions
Although the interpretation of these data is difficult because only a few data are available to compare our results, it could be demonstrated that emotional support and the ability to maintain a daily routine in additionally irradiated breast cancer patients is important to optimise hrqol. If hrqol decreases during the course of radiotherapy, the function scales of the EORTC-QOL-C30 seem to be insensitive to reflect this decrease.
References
Aaronson NK, Bullinger M, Ahmedzai S (1988) A modular approach to Quality-of-Life assessment in Cancer Clinical Trials. Recent Results Cancer Res 111:231–249
Allal AS, Gervaz P, Gertsch P, Bernier J, Roth AD, Morel P, Bieri S (2005) Assessment of quality of life in patients with rectal cancer treated by preoperative radiotherapy: a longitudinal prospective study. Int J Radiat Oncol Biol Phys 46(4):1129–1135
Back M, Ahern V, Delaney G, Graham P, Steigler A, Wratten C (2005) Absence of adverse early quality of life outcomes of radiation therapy in breast conservation therapy for early breast cancer. Australas Radiol 49:39–43
Bansal M, Mohanti BK, Shah N, Chaudhry R, Bahadur S, Shukla NK (2004) Radiation related morbidities and their impact on quality of life in head and neck cancer patients receiving radical radiotherapy. Qual Life Res 13:481–488
Bozcuk H, Artac M, Kara A, Ozdogan M, Sualp Y, Topcu Z, Karaagacli A, Yildiz M, Savas B (2006) Does music exposure during chemotherapy improve quality of life in early breast cancer patients? A pilot study. Med Sci Monit 12(5):200–205
Fang FM, Chien CY, Kuo SC, Chiu HC, Wang CJ (2004) Changes in quality of life of head-and-neck cancer patients following postoperative radiotherapy. Acta Oncol 43:571–578
Genre D, Protiére C, Macquart-Moulin G, Gravis G, Camerlo J, Alzieu C, Maraninchi D, Moatti JP, Viens P (2002) Quality of life of breast cancer patients receiving high-dose intensity chemotherapy: impact of length of cycles. Support Care Cancer 10(3):222–230
Gustafsson M, Edvardsson T, Ahlstrom G (2006) The relationship between function, quality of life and coping in patients with low-grade gliomas. Support Care Cancer 14(12):1205–1212
Herschbach P (2002) Das “Zufriedenheitsparadox” in der Lebensqualitätsforschung. Psychother Psychosom med Psychol 52:141–150
Lamszus K, Verres R (1995) Ansprechpartner von Strahlentherapiepatienten bei seelischen Belastungen und in Krisensituationen. Strahlenther Onkol 171:408–414
Lamszus K, Verres R. (1998). Strahlentherapie im Erleben des Patienten. In: Verres R, Klusmann D (eds), Strahlentherapie im Erleben des Patienten. Johann Ambrosius Barth Verlag Heidelberg, Leipzig, pp 54–65
Land SR, Kopec JA, Yothers G, Anderson S, Day R, Tang G, Ganz PA, Fisher B, Wolmark N (2004) Health-related quality of life in axillary node-negative, estrogen receptor-negative breast cancer patients undergoing AC versus CMF chemotherapy: findings from the National Surgical Adjuvant Breast and Bowel Project B-23. Breast Cancer Res Treat 86(2):153–164
Lindley C, Vasa S, Sawyer WT, Winer EP (1998) Quality of life and preferences for treatment following systemic adjuvant therapy for early-stage breast cancer. J Clin Oncol 16(4):1380–1387
Mose St, Budischewski KM, Rahn AN, Zander-Heinz AC, Bormeth S, Boettcher HD (2001) Influence of irradiation on therapy-associated psychological distress in breast carcinoma patients. Int J Radiat Oncol Biol Phys 51(5):1328–1335
Mould RF (1998) Introductory medical statistics. 3rd edn. Institute of Physics, Bristol
Osoba D, Aaronson N, Zee B, Sprangers M, te Velde A (1997) Modification of the EORTC QLQ-C30 (version 2.0) based on content validity and reliability testing in large samples of patients with cancer. Qual Life Res 6:103–108
Pater J, Osoba D, Zee B, Lofters W, Gore M, Dempsey E, Palmer M, Chin C (1998) Effects of altering the time of administration and the time frame of quality of life assessments in clinical trials: an example using the EORTC QLQ-C30 in a large anti-emetic trial. Qual Life Res 7:273–278
Ringdal GI, Ringdal K (2000) A follow-up study of quality of life in cancer patients with different prognoses. Qual Life Res 9:65–73
Schlömer U (1994) Psychologische Unterstützung in der Strahlentherapie. 1st edn. Springer, New York
Schwarz R (1996) Angst und Depressionen bei Krebskranken. Onkologe 2:582–592
Sehlen S, Hollenhorst H, Schymura B, Song R, Aydemir U, v. Steinbüchel N, Dühmke E (2000) Radiotherapy: Impact of quality of life and need for psychological care: Results of a longitudinal study. Onkologie 23:565–570
Sinsheimer LM, Holland JC (1987) Psychological issues in breast cancer. Semin Oncol 14(1):75–82
Tasmuth T, von Smitten K, Kalso E (1996) Pain and other symptoms during the first year after radical and conservative surgery for breast cancer. Br J Cancer 74(12):2024–2031
Taylor SE, Lichtman RR, Wood JV, Bluming AZ, Dosik GM, Leibowitz RL (1985) Illness-related and treatment-related factors in psychological adjustment to breast cancer. Cancer 55(10):2506–2513
Ulander K, Jeppsson B, Grahn G (1997) Quality of life and independence in activities of daily living preoperatively and at follow-up in patients with colorectal cancer. Support Care Cancer 5(5):402–409
Whelan TJ, Levine M, Julian J, Kirkbride P, Skingley P (2000) The effects of radiation therapy on quality of life of women with breast carcinoma. Cancer 88(10):2260–2266
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Budischewski, K., Fischbeck, S. & Mose, S. Quality of life of breast cancer patients in the course of adjuvant radiotherapy. Support Care Cancer 16, 299–304 (2008). https://doi.org/10.1007/s00520-007-0321-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-007-0321-0