Early effects of contemporary breast radiation on health-related quality of life - predictors of radiotherapy-related fatigue

Abstract

Background and purpose: The aim of this study was to report on early effects of contemporary radiotherapy (RT) on health-related quality of life (HRQOL) and explore treatment-related contributors to the development of fatigue during RT in breast cancer (BC) patients.

Material and methods: Consecutive BC patients (n = 248) referred for postoperative RT at St. Olavs University Hospital in Trondheim, Norway were enrolled from February 2007 to October 2008. Clinical- and treatment data were recorded, and HRQOL were assessed before starting (baseline) and immediately after ending RT using the "EORTC QLQ-C30" and the breast module "EORTC QLQ-BR23". Change scores from baseline were calculated. Predictors of increased fatigue during RT were explored with multiple regression analysis adjusted for relevant confounders.

Results: The global QOL- and all functional scales remained stable, except for "future perspective" which improved significantly during RT. Breast symptoms and fatigue increased significantly during RT. Groups with elevated baseline fatigue remained more stable during RT than those with lower levels at baseline. The body volume receiving 40 Gy or more (V40) was a significant predictor of increased fatigue during RT adjusted for chemotherapy, comorbidity and age (p = 0.035).

Conclusion: Contemporary RT has limited early effects on HRQOL. V40 is a significant predictor of RT-related fatigue.