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HRQoL was assessed using EORTC QLQ-C30 at pre-RT (baseline), during RT, 6\u00a0weeks 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u00a0weeks 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\u00a0years 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\u00a0years post-RT and controls for all age groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). 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\u00a0years, 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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\u00a0years, 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11136-023-03408-y","type":"journal-article","created":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T11:02:36Z","timestamp":1682334156000},"page":"2639-2652","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Longitudinal changes of health-related quality of life over 10\u00a0years in breast cancer patients treated with radiotherapy following breast-conserving surgery"],"prefix":"10.1007","volume":"32","author":[{"given":"Yifeng","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan C.","family":"Rosas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Fink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Behrens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Chang-Claude","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7360-6335","authenticated-orcid":false,"given":"Petra","family":"Seibold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,4,24]]},"reference":[{"key":"3408_CR1","unstructured":"Robert Koch Institute, Association of Population-based Cancer Registries in Germany (GEKID). 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