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

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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 develo** CRF influenced by previous treatments. Therefore, patient selection seems to be critical when interventional studies addressing CRF during radiotherapy are designed.

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Author information

Authors and Affiliations

  1. Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler- Str. 3, 72076, Tübingen, Germany

    Franziska Hauth, Chiara De-Colle, Nicola Weidner, Vanessa Heinrich, Daniel Zips & Cihan Gani

  2. German Cancer Research Center (DKFZ), Heidelberg and German Consortium for Translational Cancer Research (DKTK) Partner Site Tübingen, Tübingen, Germany

    Chiara De-Colle, Daniel Zips & Cihan Gani

Authors
  1. Franziska Hauth
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  2. Chiara De-Colle
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  4. Vanessa Heinrich
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  5. Daniel Zips
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  6. Cihan Gani
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Corresponding author

Correspondence to Franziska Hauth.

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Conflict of interest

F. Hauth, and C. Gani are involved in a clinical trial testing the impact of activity trackers for cancer related fatigue (NCT04506476). The trial is supported by Beurer GmbH, Ulm, Germany. C. De‑Colle, N. Weidner, V. Heinrich, and D. Zips declare that they have no competing interests.

Caption Electronic Supplementary Material

66_2020_1700_MOESM1_ESM.png

Suppl. Fig. 1: Results for patients treated with (red line) and without (blue line) chemotherapy for fatigue (a), physical wellbeing (b), emotional wellbeing (c), social wellbeing (d), functional wellbeing (e) and FACT‑G sum score (f). Development of scores is shown for timepoints prior and post radiotherapy as well as follow-up. Asterisk indicating significant results. mean values for single time points are shown ± standard deviation. Chemo chemotherapy, Fx fractionation, BL Baseline score, RT radiotherapy

Supp. Table 1: Recruitment process and data available for analysis

66_2020_1700_MOESM3_ESM.png

Suppl. Table 2: Patient characteristics subdivided into patients with normofrationated vs. hypofractionated irradiation treatment. n number of patients, RT radiotherapy, BCS Breast Conserving Surgery

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Hauth, F., De-Colle, C., Weidner, N. et al. Quality of life and fatigue before and after radiotherapy in breast cancer patients. Strahlenther Onkol 197, 281–287 (2021). https://doi.org/10.1007/s00066-020-01700-1

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  • DOI: https://doi.org/10.1007/s00066-020-01700-1

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