TY - JOUR
T1 - Impact of radiation therapy on fatigue at 1 year in breast cancer survivors in the prospective multicentre CANcer TOxicity cohort
AU - Ghannam, Youssef
AU - Di Meglio, Antonio
AU - Sarrade, Thomas
AU - Jacquet, Alexandra
AU - Everhard, Sibille
AU - Kirova, Youlia
AU - Peignaux, Karine
AU - Guilbert, Philippe
AU - Charra-Brunaud, Claire
AU - Blanchecotte, Julien
AU - Bochaton, Odile Fargier
AU - Pasquier, David
AU - Racadot, Séverine
AU - Bourgier, Céline
AU - Geffrelot, Julien
AU - Benyoucef, Ahmed
AU - Paris, François
AU - Auzac, Guillaume
AU - Luis, Inès Vaz
AU - Rivera, Sofia
N1 - Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Background: Fatigue is a common and disabling symptom after breast cancer (BC) treatment, significantly impacting patients' quality of life. We aimed to assess the impact of radiation therapy (RT) modalities on fatigue one year after treatment among patients with early-stage BC. Methods: We used CANTO-RT, a subcohort of CANcer TOxicity (CANTO; NCT01993498), a multicentric nationwide prospective cohort of stages I–III BC treated from 2012 to 2017. Our primary outcome was severe global fatigue 1 year after RT completion (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 score ≥40/100). The secondary outcomes included severe physical, emotional and cognitive fatigue (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-FA12). RT-related variables were used as independent variables. Multivariable logistic regression models assessed associations between RT-related variables and fatigue. Results: The final analytic cohort included 3295 patients. The prevalence of severe global fatigue 1 year after treatment was 33.3%. Internal mammary chain RT (adjusted odds ratio [OR] 1.48 [95% confidence interval [CI] 1.03–2.13; p = 0.0355]) and normofractionated RT (adjusted OR 1.88 [95% CI 1.06–3.31; p = 0.0298]) were associated with increased odds of severe global fatigue. In addition, there was a significant association between normofractionated RT (adjusted OR 1.849 [95% CI 1.04–3.3; p = 0.0354]) and an increased likelihood of severe physical fatigue. Conclusion: We found a significant association between internal mammary chain RT (versus No), normofractionated RT (versus hypofractionated RT) and increased likelihood of persistent severe global fatigue. Our data add to the current understanding of treatment-related factors affecting fatigue after BC and could lead to personalised interventions to improve the prevention and management of this disabling symptom.
AB - Background: Fatigue is a common and disabling symptom after breast cancer (BC) treatment, significantly impacting patients' quality of life. We aimed to assess the impact of radiation therapy (RT) modalities on fatigue one year after treatment among patients with early-stage BC. Methods: We used CANTO-RT, a subcohort of CANcer TOxicity (CANTO; NCT01993498), a multicentric nationwide prospective cohort of stages I–III BC treated from 2012 to 2017. Our primary outcome was severe global fatigue 1 year after RT completion (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 score ≥40/100). The secondary outcomes included severe physical, emotional and cognitive fatigue (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-FA12). RT-related variables were used as independent variables. Multivariable logistic regression models assessed associations between RT-related variables and fatigue. Results: The final analytic cohort included 3295 patients. The prevalence of severe global fatigue 1 year after treatment was 33.3%. Internal mammary chain RT (adjusted odds ratio [OR] 1.48 [95% confidence interval [CI] 1.03–2.13; p = 0.0355]) and normofractionated RT (adjusted OR 1.88 [95% CI 1.06–3.31; p = 0.0298]) were associated with increased odds of severe global fatigue. In addition, there was a significant association between normofractionated RT (adjusted OR 1.849 [95% CI 1.04–3.3; p = 0.0354]) and an increased likelihood of severe physical fatigue. Conclusion: We found a significant association between internal mammary chain RT (versus No), normofractionated RT (versus hypofractionated RT) and increased likelihood of persistent severe global fatigue. Our data add to the current understanding of treatment-related factors affecting fatigue after BC and could lead to personalised interventions to improve the prevention and management of this disabling symptom.
KW - Breast cancer
KW - Fatigue
KW - Hypofractionation
KW - Internal mammary chain
KW - Normofractionation
KW - Quality of life
KW - Radiation therapy
KW - Survivorship
UR - http://www.scopus.com/inward/record.url?scp=85141663192&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2022.09.026
DO - 10.1016/j.ejca.2022.09.026
M3 - Article
C2 - 36356418
AN - SCOPUS:85141663192
SN - 0959-8049
VL - 177
SP - 143
EP - 153
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -