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@ARTICLE{Li:298614,
      author       = {K. Li and M. Chadha and E. Moshier and B. S. Rosenstein},
      collaboration = {R. consortium},
      othercontributors = {H. K. Jandu and C. D. Veal and L. Fachal and C. Luccarini
                          and M. E. Aguado-Barrera and M. Altabas and D. Azria and A.
                          Baten and C. Bourgier and R. Bultijnck and R. R. Colciago
                          and M.-P. Farcy-Jacquet and J. Chang-Claude$^*$ and A.
                          Choudhury and A. Dunning and R. M. Elliott and S. Green and
                          S. Gutiérrez-Enríquez and C. Herskind and M. Lambrecht and
                          C. Monten and T. Rancati and V. Reyes and D. De Ruysscher
                          and M. C. De Santis and P. Seibold$^*$ and E. Sperk and M.
                          R. Veldwijk and R. P. Symonds and H. Stobart and B.
                          Taboada-Valladares and A. Vega and L. Veldeman and A. J.
                          Webb and C. Weltens and C. M. West and T. Rattay and C. J.
                          Talbot},
      title        = {{A}ge-stratified analysis of health-related quality of life
                      in patients with early-stage breast cancer receiving
                      adjuvant radiation therapy and endocrine therapy.},
      journal      = {Journal of geriatric oncology},
      volume       = {16},
      number       = {2},
      issn         = {1879-4068},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2025-00314},
      pages        = {102195},
      year         = {2025},
      abstract     = {Health-related quality of life (HRQoL) in older patients
                      with breast cancer (BC) (≥70 years) is not well studied.
                      This study assesses aging-related differences in
                      patient-reported outcomes among estrogen receptor-positive
                      (ER+) patients with BC treated with breast conservation
                      surgery (BCS), radiation therapy (RT), and endocrine therapy
                      (ET).Among the 2,057 patients with ER+ early-stage BC
                      enrolled in the prospective multicenter REQUITE study, 1,003
                      patients receiving adjuvant RT + ET as the only systemic
                      therapy constitute our study population. Patients were
                      stratified by age into younger (<70 years, n = 810 patients)
                      and older (≥70 years, n = 193 patients) groups.
                      Prospectively collected HRQoL was measured using the
                      validated European Organization for Research and Treatment
                      of Cancer (EORTC) quality of life of cancer patients
                      (QLQ-30) and breast cancer-specific quality of life
                      (QLQ-BR23), and Multidimensional Fatigue Inventory (MFI-20)
                      measures at baseline following BCS and pre-adjuvant
                      treatment, post-RT, and at one-year, two-year, and
                      three-year intervals. Statistical analysis involved a mixed
                      model analysis of variance, weighted by propensity
                      scoring.Older patients had a higher burden of comorbidities,
                      larger tumor size, and higher rates of N1 disease compared
                      to the younger group. RT boost to the lumpectomy site was
                      more often delivered in younger participants (72 $\%)$
                      compared to older (50 $\%).$ Younger patients predominately
                      received tamoxifen (63.5 $\%),$ while older patients more
                      commonly received aromatase inhibitors (67.4 $\%).$
                      Throughout the follow-up, we observed that the younger
                      patients showed greater recovery in QoL domains including
                      sexual enjoyment, systemic side effects, breast symptoms,
                      global health status, and emotional, physical, and social
                      functioning compared to the older group. Cognitive function,
                      which declined from baseline in both groups, improved over
                      time in younger participants but persisted at lower levels
                      in older patients at the three-year follow-up
                      period.Adjuvant treatments differentially impacted HRQoL,
                      with older patients experiencing greater and more persistent
                      adverse effects compared to younger counterparts. These
                      findings underscore the need for tailored interventions that
                      address the unique challenges in HRQoL recovery among older
                      BC survivors.},
      keywords     = {Early-stage breast cancer, estrogen receptor positive
                      (Other) / Endocrine therapy (Other) / Health-related quality
                      of life (Other) / Lumpectomy (Other) / Older women (Other) /
                      Patient-reported outcomes (Other) / Radiation therapy
                      (Other)},
      cin          = {C020},
      ddc          = {610},
      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:39919652},
      doi          = {10.1016/j.jgo.2025.102195},
      url          = {https://inrepo02.dkfz.de/record/298614},
}