Breast cancer patients who undergo radiation therapy following breast conservation surgery have complained for decades about radiation-induced fatigue. It is often severe enough to disrupt a patient's personal life or job performance.
An analysis comparing fatigue levels experienced by women who received conventional radiation therapy, accelerated hypofractionated radiation therapy, and accelerated partial-breast irradiation (APBI), published online March 1 in Cancer, revealed the winner from a patient's perspective to be APBI treatment.
In this small, retrospective study, researchers from the Cancer Institute of New Jersey analyzed fatigue levels experienced by 161 women who received treatment there between April 2005 and September 2010. The 35 women who received APBI treatments and the 45 women who received accelerated hypofractionated radiation therapy were enrolled in two separate clinical trials.
Eighty-one women who had received conventional whole-breast irradiation were matched by age (37 to 84 years) and tumor stage with the women receiving the accelerated regimens.
Radiation therapy (RT) treatment
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All patients were assessed for fatigue at the time of the initial patient consultation, the first treatment visit, halfway through treatment, on the last visit, and four weeks following treatment completion. Records were reviewed to determine maximum fatigue and average fatigue levels from start of treatment through the one-month follow-up, according to co-author Dr. Sharad Goyal, of the department of radiation oncology, and colleagues.
The researchers evaluated patient age, race, tumor stage, estrogen and progesterone receptor status, chemotherapy and hormone therapy use, and radiation therapy dose and technique. Baseline level of fatigue, if any, was also considered.
Goyal and colleagues found that older age and larger radiation field sizes were associated with greater fatigue. Neither chemotherapy nor hormone therapy treatments had any impact.
Median fatigue level scores
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Patients who received APBI experienced less severe maximum fatigue and less severe fatigue at treatment completion than those in the other treatment groups, according to the researchers.
