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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 4/2021

01-04-2021 | Breast Cancer | Original Article

Quality of life and fatigue before and after radiotherapy in breast cancer patients

Authors: Dr. Franziska Hauth, Chiara De-Colle, Nicola Weidner, Vanessa Heinrich, Daniel Zips, Cihan Gani

Published in: Strahlentherapie und Onkologie | Issue 4/2021

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Abstract

Background and purpose

Cancer-related fatigue (CRF) is a common side effect of cancer treatment, particularly in breast cancer patients. Over the past decade, the multimodal management of breast cancer has undergone several changes, such as the establishment of postoperative hypofractionated radiotherapy (RT) as a new standard protocol and the reduced use of chemotherapy. The aim of the current study was to investigate the impact of these changes on quality of life (QoL) and CRF.

Methods

A total of 66 patients was assessed for QoL and CRF using the FACIT‑F questionnaire. Patients were asked to complete the paper-based questionnaire before (TP1) and at the end of radiotherapy (TP2) as well as at follow-up (TP3). Subgroups were compared based on fractionation and previous application of chemotherapy.

Results

For the entire cohort, no significant changes in the severity of fatigue were seen. A mild decrease of physical wellbeing (PWB) from TP1 to TP2 was observed (22.2 vs. 20.7, p = 0.007). Fatigue at TP1 was more severe in patients receiving chemotherapy before RT (37.9 vs. 30.5, p = 0.041). Only patients without preceding chemotherapy showed a significant worsening of fatigue from TP1 to TP2 (37.9 vs 34.8, p = 0.005). The same is true for physical wellbeing (PWB), with a decrease from TP1 to TP2 in chemotherapy-naïve patients only (23.5 vs. 21.4, p = 0.002). Fractionation did not impact any of the investigated endpoints.

Conclusion

Patients undergoing postoperative RT for breast cancer constitute a heterogeneous patient population with varying risks of developing CRF influenced by previous treatments. Therefore, patient selection seems to be critical when interventional studies addressing CRF during radiotherapy are designed.
Appendix
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Literature
1.
Sedlmayer F, Sautter-Bihl ML, Budach W et al (2013) DEGRO practical guidelines: radiotherapy of breast cancer I: radiotherapy following breast conserving therapy for invasive breast cancer. Strahlenther Onkol 189:825–833CrossRef
2.
(2017) Brustdrüse. In: Robert Koch-Institut, Gesellschaft der epidemiologischen Krebsregister (eds) Krebs in Deutschland für 2013/2014. 11. Ausgabe. RKI, Berlin
3.
International Agency for Research on Cancer (2019) The Global Cancer Observatory: Germany factsheet
4.
Wang XS, Woodruff JF (2015) Cancer-related and treatment-related fatigue. Gynecol Oncol 136:446–452CrossRef
5.
Ebede CC, Jang Y, Escalante CP (2017) Cancer-related fatigue in cancer survivorship. Med Clin North Am 101:1085–1097CrossRef
6.
Mohandas H, Jaganathan SK, Mani MP, Ayyar M, Rohini Thevi GV (2017) Cancer-related fatigue treatment: an overview. J Can Res Ther 13:916–929
7.
Rezende LFM, Sá TH, Markozannes G et al (2018) Physical activity and cancer: an umbrella review of the literature including 22 major anatomical sites and 770 000 cancer cases. Br J Sports Med 52:826–833CrossRef
8.
LaVoy EC, Fagundes CP, Dantzer R (2016) Exercise, inflammation, and fatigue in cancer survivors. Exerc Immunol Rev 22:82–93PubMedPubMedCentral
9.
Louati K, Berenbaum F (2015) Fatigue in chronic inflammation—a link to pain pathways. Arthritis Res Ther 17:254CrossRef
10.
Reidunsdatter RJ, Rannestad T, Frengen J, Frykholm G, Lundgren S (2011) Early effects of contemporary breast radiation on health-related quality of life—predictors of radiotherapy-related fatigue. Acta Oncol 50:1175–1182CrossRef
11.
Hickok JT, Roscoe JA, Morrow GR, Mustian K, Okunieff P, Bole CW (2005) Frequency, severity, clinical course, and correlates of fatigue in 372 patients during 5 weeks of radiotherapy for cancer. Cancer 104:1772–1778CrossRef
12.
Hickok JT, Morrow GR, Roscoe JA, Mustian K, Okunieff P (2005) Occurrence, severity, and longitudinal course of twelve common symptoms in 1129 consecutive patients during radiotherapy for cancer. J Pain Symptom Manage 30:433–442CrossRef
13.
Lipsett A, Barrett S, Haruna F, Mustian K, O’Donovan A (2017) The impact of exercise during adjuvant radiotherapy for breast cancer on fatigue and quality of life: a systematic review and meta-analysis. Breast 32:144–155CrossRef
14.
Kurian AW, Bondarenko I, Jagsi R et al (2018) Recent trends in chemotherapy use and oncologists’ treatment recommendations for early-stage breast cancer. J Natl Cancer Inst 110:493–500CrossRef
15.
Kolberg HC, Schneeweiss A, Fehm TN et al (2019) Update breast cancer 2019 part 3—current developments in early breast cancer: review and critical assessment by an international expert panel. Geburtshilfe Frauenheilkd 79:470–482CrossRef
16.
Krug D, Baumann R, Budach W et al (2018) Neoadjuvant chemotherapy for breast cancer-background for the indication of locoregional treatment. Strahlenther Onkol 194:797–805CrossRef
17.
Bentzen SM, Agrawal RK, Aird EG et al (2008) The UK Standardisation of Breast Radiotherapy (START) trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet 371:1098–1107CrossRef
18.
Yarnold J (2019) Changes in radiotherapy fractionation-breast cancer. Br J Radiol 92:20170849PubMed
19.
Whelan TJ, Pignol JP, Levine MN et al (2010) Long-term results of hypofractionated radiation therapy for breast cancer. N Engl J Med 362:513–520CrossRef
20.
Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E (1997) Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manage 13:63–74CrossRef
21.
Van Belle S, Paridaens R, Evers G et al (2005) Comparison of proposed diagnostic criteria with FACT‑F and VAS for cancer-related fatigue: proposal for use as a screening tool. Support Care Cancer 13:246–254CrossRef
22.
Courtier N, Gambling T, Enright S, Barrett-Lee P, Abraham J, Mason MD (2013) A prognostic tool to predict fatigue in women with early-stage breast cancer undergoing radiotherapy. Breast 22:504–509CrossRef
23.
Bower JE, Ganz PA, Desmond KA et al (2006) Fatigue in long-term breast carcinoma survivors: a longitudinal investigation. Cancer 106:751–758CrossRef
24.
Tribius S, Meyer MS, Pflug C et al (2018) Socioeconomic status and quality of life in patients with locally advanced head and neck cancer. Strahlenther Onkol 194:737–749CrossRef
25.
Schmitz KH, Speck RM, Rye SA, DiSipio T, Hayes SC (2012) Prevalence of breast cancer treatment sequelae over 6 years of follow-up: the Pulling Through Study. Cancer 118:2217–2225CrossRef
26.
Hauth F, Bizu V, App R et al (2019) Electronic patient-reported outcome measures in radiation oncology: initial experience after workflow implementation. JMIR Mhealth Uhealth 7:e12345CrossRef
27.
Welzel G, Hägele V, Wenz F, Mai SK (2011) Quality of life outcomes in patients with anal cancer after combined radiochemotherapy. Strahlenther Onkol 187:175–182CrossRef
28.
de Jong N, Candel MJ, Schouten HC, Abu-Saad HH, Courtens AM (2004) Prevalence and course of fatigue in breast cancer patients receiving adjuvant chemotherapy. Ann Oncol 15:896–905CrossRef
29.
Abrahams HJ, Gielissen MF, Schmits IC, Verhagen CA, Rovers MM, Knoop H (2016) Risk factors, prevalence, and course of severe fatigue after breast cancer treatment: a meta-analysis involving 12 327 breast cancer survivors. Ann Oncol 27:965–974CrossRef
30.
Berger AM, Gerber LH, Mayer DK (2012) Cancer-related fatigue: implications for breast cancer survivors. Cancer 118:2261–2269CrossRef
31.
Manir KS, Bhadra K, Kumar G, Manna A, Patra NB, Sarkar SK (2012) Fatigue in breast cancer patients on adjuvant treatment: course and prevalence. Indian J Palliat Care 18:109–116CrossRef
32.
Montgomery GH, David D, Kangas M et al (2014) Randomized controlled trial of a cognitive-behavioral therapy plus hypnosis intervention to control fatigue in patients undergoing radiotherapy for breast cancer. J Clin Oncol 32:557–563CrossRef
33.
Engberg I, Segerstedt J, Waller G, Wennberg P, Eliasson M (2017) Fatigue in the general population-associations to age, sex, socioeconomic status, physical activity, sitting time and self-rated health: the northern Sweden MONICA study 2014. BMC Public Health 17:654CrossRef
34.
Donovan KA, Jacobsen PB, Andrykowski MA et al (2004) Course of fatigue in women receiving chemotherapy and/or radiotherapy for early stage breast cancer. J Pain Symptom Manage 28:373–380CrossRef
35.
Sprangers MA, Schwartz CE (1999) Integrating response shift into health-related quality of life research: a theoretical model. Soc Sci Med 48:1507–1515CrossRef
36.
Haviland JS, Owen JR, Dewar JA et al (2013) The UK Standardisation of Breast Radiotherapy (START) trials of radiotherapy hypofractionation for treatment of early breast cancer: 10-year follow-up results of two randomised controlled trials. Lancet Oncol 14:1086–1094CrossRef
37.
Jagsi R, Griffith KA, Boike TP et al (2015) Differences in the acute toxic effects of breast radiotherapy by fractionation schedule: comparative analysis of physician-assessed and patient-reported outcomes in a large multicenter cohort. JAMA Oncol 1:918–930CrossRef
38.
Shaitelman SF, Schlembach PJ, Arzu I et al (2015) Acute and short-term toxic effects of conventionally fractionated vs hypofractionated whole-breast irradiation: a randomized clinical trial. JAMA Oncol 1:931–941CrossRef
39.
Zeng Y, Xie X, Cheng ASK (2019) Qigong or tai chi in cancer care: an updated systematic review and meta-analysis. Curr Oncol Rep 21:48CrossRef
40.
Zhang Y, Lin L, Li H, Hu Y, Tian L (2018) Effects of acupuncture on cancer-related fatigue: a meta-analysis. Support Care Cancer 26:415–425CrossRef
41.
Mendoza ME, Capafons A, Gralow JR et al (2017) Randomized controlled trial of the Valencia model of waking hypnosis plus CBT for pain, fatigue, and sleep management in patients with cancer and cancer survivors. Psychooncology 26:1832–1838CrossRef
Metadata
Title
Quality of life and fatigue before and after radiotherapy in breast cancer patients
Authors
Dr. Franziska Hauth
Chiara De-Colle
Nicola Weidner
Vanessa Heinrich
Daniel Zips
Cihan Gani
Publication date
01-04-2021
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 4/2021
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-020-01700-1

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