Parm. Lind et al., Pulmonary function following adjuvant chemotherapy and radiotherapy for breast cancer and the issue of three-dimensional treatment planning, RADIOTH ONC, 49(3), 1998, pp. 245-254
Citations number
16
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Onconogenesis & Cancer Research
Background and purpose: The frequency and grade of pulmonary complications
following adjuvant radiotherapy for breast cancer are still debated. This s
tudy focuses on loss of pulmonary function.
Materials and methods: We have measured the reduction of pulmonary function
5 months following radiotherapy in 144 node-positive stage II breast cance
r patients by using pulmonary function tests.
Results: No deterioration of pulmonary function was detected among the pati
ents who were treated with local radiotherapy. On the contrary, there was a
mean increase in diffusion capacity by 7% (P = 0.004) following radiothera
py, which most likely was explained by the adjuvant chemotherapy administer
ed prior to the baseline pulmonary function tests. Patients undergoing loco
-regional radiotherapy showed a mean reduction in diffusion capacity by 5%
(P < 0.001) and in vital capacity by 3% (P = 0.001). The subset of patients
(9%) who were diagnosed with severe pulmonary complications needing cortis
one treatment had significantly larger mean paired differences in vital cap
acity (-0.446 L, -15% (equivalent to 15 years of normal ageing or the loss
of 3/4 of a lung lobe)) compared to the patients who were asymptomatic (-0.
084 L) (P < 0.05). When the effects of potential confounding factors and di
fferent radiotherapy techniques were tested on the reduction of pulmonary f
unction by stepwise multiple regression analysis, a significant correlation
was found only to locoregional radiotherapy including the lower internal m
ammary lymph nodes.
Conclusions: We conclude that a clinically important reduction of pulmonary
function is seen in the subset of patients who are diagnosed with severe p
ulmonary complication following loco-regional radiotherapy for breast cance
r. The results of this study warrant further studies based on individual lu
ng dose volume histograms. (C) 1999 Elsevier Science Ireland Ltd. All right
s reserved.