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@ARTICLE{Gao:275611,
      author       = {Y. Gao$^*$ and J. C. Rosas$^*$ and H. Fink$^*$ and S.
                      Behrens$^*$ and J. Chang-Claude$^*$ and P. Seibold$^*$},
      title        = {{L}ongitudinal changes of health-related quality of life
                      over 10 years in breast cancer patients treated with
                      radiotherapy following breast-conserving surgery.},
      journal      = {Quality of life research},
      volume       = {32},
      number       = {9},
      issn         = {0962-9343},
      address      = {Dordrecht [u.a.]},
      publisher    = {Springer Science + Business Media B.V},
      reportid     = {DKFZ-2023-00817},
      pages        = {2639-2652},
      year         = {2023},
      note         = {#EA:C020#LA:C020# / 2023 Sep;32(9):2639-2652},
      abstract     = {The study intended to (1) assess changes of health-related
                      quality of life (HRQoL) between early treatment-related time
                      points and 10 years post-treatment in a cohort of breast
                      cancer (BC) patients who received radiotherapy (RT), (2) to
                      evaluate differences in HRQoL between long-term BC survivors
                      and unaffected women from the same geographical region and
                      (3) to identify determinants of long-term HRQoL in the
                      survivor cohort.292 BC patients were recruited prior to RT
                      after breast-conserving surgery between 1998 and 2001 in
                      Germany and prospectively followed up for a median of
                      11.4 years (range 10.3-12.8 years). HRQoL was assessed
                      using EORTC QLQ-C30 at pre-RT (baseline), during RT,
                      6 weeks after RT, and at the 10-year follow-up. Changes in
                      mean HRQoL scores over time were assessed using linear-mixed
                      models. HRQoL in long-term survivors and controls was
                      compared using Wilcoxon rank-sum test, stratified by age
                      groups. Multivariable linear regression models were used to
                      identify determinants for HRQoL in long-term BC
                      survivors.Compared to baseline level (mean summary score of
                      64.9), global health status/quality of life (GHS/QoL)
                      declined during RT (62.4) and improved 6 weeks after RT
                      (69.9) before decreasing to baseline level at the 10-year
                      follow-up (66.7). Most functional domains deteriorated or
                      remained stable at 10 years post-diagnosis compared to
                      post-RT scores, except for role functioning which improved,
                      while dyspnea and diarrhea significantly deteriorated
                      between those two time points. There were no significant
                      differences in long-term GHS/QoL between BC survivors
                      10 years post-RT and controls for all age groups (p >
                      0.05). However, deficits in specific HRQoL domains such as
                      emotional burden, sleep problems or fatigue were found to
                      more strongly affect survivors, in particular those younger
                      than 65 years, compared to controls. In the determinant
                      analysis, being overweight was associated with lower GHS/QoL
                      and physical functioning, while living with others was found
                      to be associated with better physical functioning, and
                      decreased dyspnea and pain levels. Certain comorbidities
                      such as depression had a strong association with multiple
                      HRQoL domains, including lower GHS/QoL and functioning as
                      well as a higher level of fatigue, pain, sleep/intestinal
                      problems, and financial difficulties. Side effects such as
                      lymphedema/pain and fibrosis were associated with worse
                      physical and social functioning, respectively.The long-term
                      GHS/QoL remained comparable when compared with the control
                      population while restrictions in certain functional and
                      symptoms domains in long-term BC survivors persisted over
                      10 years, in particular among younger survivors. Targeted
                      screening to identify cancer survivors at risk for
                      psychosocial/other impairment accounting also for
                      comorbidities and treatment side effects may be warranted in
                      long-term aftercare to address unmet health needs.},
      keywords     = {Adjuvant radiotherapy (Other) / Breast cancer (Other) /
                      Health-related quality of life (Other) / Long-term symptoms
                      (Other) / Sleep problems (Other) / Survivorship (Other)},
      cin          = {C020},
      ddc          = {100},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37093543},
      doi          = {10.1007/s11136-023-03408-y},
      url          = {https://inrepo02.dkfz.de/record/275611},
}