A comparison of quality of life and acute toxicity in patients applied with Tomo-helical IMRT and conformal radiotherapy
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ORIGINAL RESEARCH
A comparison of quality of life and acute toxicity in patients applied with Tomo-helical IMRT and conformal radiotherapy for breast cancer Eda Erdis 1
&
Birsen Yucel 1 & Seher Bahar 2
Received: 19 December 2019 / Accepted: 27 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Aim To compare quality of life and radiation toxicity in patients applied with Tomo-helical intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3D-CRT) as adjuvant radiotherapy because of breast cancer. Material and method The study included a total of 403 patients. Fifty-eight percent of patients were treated with 3D-CRT, and 42% of patients were treated with Tomo-helical IMRT. Radiation toxicity was evaluated according to the Radiation Therapy Oncology Group (RTOG) toxicity criteria. Quality of life was evaluated using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 Quality of life scale version 3-Turkish and the EORTC QLQ-BR23 questionnaires. These questionnaires were completed by all patients at 4 different time points: the start of RT (T1); the end of RT (T2); 1 month after completion of RT (T3); and 6 months after completion of RT (T4). Statistical data were analysed using the Chi-square and MANOVA tests. Results Radiotherapy-related skin, upper gastro-intestinal system, white blood count and neutrophil toxicity were observed to be higher in the patients treated with 3D-CRT (p < 0.001). No difference was determined between the radiotherapy techniques according to the EORTC-C30 (p > 0.050). In the patients treated with Tomo-helical IMRT, the scores of breast symptoms (p = 0.014), sexual function (p = 0.003) and sexual pleasure (p = 0.020) in the sub-dimension scales of the EORTC-BR23 were found to be better compared with those of patients treated with 3D-CRT. Conclusion The findings of RT toxicity and quality of life appear to be superior in patients applied with Tomo-helical IMRT compared with patients treated with 3D-CRT. Keywords Radiotherapy . Tomotherapy . Conformal radiotherapy . Breast cancer . Quality of life
Introduction In current treatment approaches to breast cancer, adjuvant radiotherapy (RT) has an important role in providing the best
* Eda Erdis [email protected] Birsen Yucel [email protected] Seher Bahar [email protected] 1
Department of Radiation Oncology, Medical School of Cumhuriyet University, 58140 Sivas, Turkey
2
Department of Radiation Oncology, Medical School of Gazi Osman Paşa University, Sivas, Turkey
local control and improving survival rates [1, 2]. Breast RT can be treated with different treatment techniques. The aim of modern RT is to gain greater control of the tumour and minimise side effects. With technological developments, the correct application of treatment has increased, thereby resulting in fewer side effects [3]. In the planning of RT, more homogenous and conformal dose distributions have started to be obtained with the use of computed tomography (CT). In 3D
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