Impact of partial versus whole breast radiation therapy on fatigue, perceived stress, quality of life and natural killer cell activity in women with breast cancer

BMC Cancer

Research Article

Herbert L Mathews¹  Linda Millbrandt²  Kevin Albuquerque³  Linda Witek Janusek⁴  Dina Tell⁴  Philip Lobo⁵ 

[1] Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA;Department of Radiation Oncology, Loyola University Health System, Maywood, IL, USA;Department of Radiation Oncology, Loyola University Health System, Maywood, IL, USA;Moncrief Radiation Oncology Center, UT Southwestern Medical Center, 5801 Forest Park Road, Dallas, USA;Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, USA;Radiation Oncology, Northwest Community Hospital, Arlington Heights, IL, USA;

关键词: Breast Radiation;    Fatigue;    Perceived Stress;    Quality of Life;    Natural Killer Cell Activity;   

DOI  :  10.1186/1471-2407-12-251

 received in 2011-12-07, accepted in 2012-05-29,  发布年份 2012

来源: Springer

【 摘 要 】

IntroductionThis pilot study used a prospective longitudinal design to compare the effect of adjuvant whole breast radiation therapy (WBRT) versus partial breast radiation therapy (PBRT) on fatigue, perceived stress, quality of life and natural killer cell activity (NKCA) in women receiving radiation after breast cancer surgery.MethodsWomen (N = 30) with early-stage breast cancer received either PBRT, Mammosite brachytherapy at dose of 34 Gy 10 fractions/5 days, (N = 15) or WBRT, 3-D conformal techniques at dose of 50 Gy +10 Gy Boost/30 fractions, (N = 15). Treatment was determined by the attending oncologist after discussion with the patient and the choice was based on tumor stage and clinical need. Women were assessed prior to initiation of radiation therapy and twice after completion of radiation therapy. At each assessment, blood was obtained for determination of NKCA and the following instruments were administered: Perceived Stress Scale (PSS), Functional Assessment of Cancer Therapy-Fatigue (FACT-F), and Functional Assessment of Cancer Therapy-General (FACT-G). Hierarchical linear modeling (HLM) was used to evaluate group differences in initial outcomes and change in outcomes over time.ResultsFatigue (FACT-F) levels, which were similar prior to radiation therapy, demonstrated a significant difference in trajectory. Women who received PBRT reported progressively lower fatigue; conversely fatigue worsened over time for women who received WBRT. No difference in perceived stress was observed between women who received PBRT or WBRT. Both groups of women reported similar levels of quality of life (FACT-G) prior to initiation of radiation therapy. However, HLM analysis revealed significant group differences in the trajectory of quality of life, such that women receiving PBRT exhibited a linear increase in quality of life over time after completion of radiation therapy; whereas women receiving WBRT showed a decreasing trajectory. NKCA was also similar between therapy groups but additional post hoc analysis revealed that better quality of life significantly predicted higher NKCA regardless of therapy.ConclusionsCompared to WBRT, PBRT results in more rapid recovery from cancer-related fatigue with improved restoration of quality of life after radiation therapy. Additionally, better quality of life predicts higher NKCA against tumor targets, emphasizing the importance of fostering quality of life for women undergoing adjuvant radiation therapy.

【 授权许可】

CC BY   
© Albuquerque et al.; licensee BioMed Central Ltd. 2012