Role of systemic therapy in the development of lung sequelae after conformal radiotherapy in breast cancer patients

Zoltán Varga, Adrienn Cserháti, Gyöngyi Kelemen, K. Boda, L. Thurzó, Z. Kahán

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: To analyze the risk of radiogenic lung damage in breast cancer patients after conformal radiotherapy and different forms of systemic treatment. Methods and Materials: In 328 patients receiving sequential taxane-based chemotherapy, concomitant hormone therapy (tamoxifen or aromatase inhibitors), or no adjuvant systemic therapy, symptomatic and asymptomatic lung sequelae were prospectively evaluated via the detection of visible CT abnormalities, 3 months or 1 year after the completion of the radiotherapy. Results: Significant positive associations were detected between the development of both pneumonitis and fibrosis of Grade 1 and patient age, ipsilateral mean lung dose, volume of the ipsilateral lung receiving 20 Gy, and irradiation of the regional lymph nodes. In multivariate analysis, age and mean lung dose proved to be independent predictors of early (odds ratio [OR] = 1.035, 95% confidence interval [CI] 1.011-1.061 and OR = 1.113, 95% CI 1.049-1.181, respectively) and late (OR = 1.074, 95% CI 1.042-1.107 and OR = 1.207, 95% CI 1.124-1.295, respectively) radiogenic lung damage, whereas the role of systemic therapy was significant in the development of Grade 1 lung fibrosis (p = 0.01). Among the various forms of systemic therapy, tamoxifen increased the risk of late lung sequelae (OR = 2.442, 95% CI 1.120-5.326, p = 0.025). No interaction was demonstrated between the administration of systemic therapy and the other above-mentioned parameters as regards the risk of radiogenic lung damage. Conclusions: Our analyses demonstrate the independent role of concomitant tamoxifen therapy in the development of radiogenic lung fibrosis but do not suggest such an effect for the other modes of systemic treatment.

Original languageEnglish
Pages (from-to)1109-1116
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume80
Issue number4
DOIs
Publication statusPublished - Jul 15 2011

Fingerprint

Conformal Radiotherapy
breast
lungs
radiation therapy
therapy
cancer
Breast Neoplasms
Lung
confidence
fibrosis
Odds Ratio
Confidence Intervals
intervals
Tamoxifen
Therapeutics
Fibrosis
damage
grade
dosage
Aromatase Inhibitors

Keywords

  • Aromatase inhibitors
  • Radiation lung sequelae
  • Tamoxifen
  • Taxanes

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Role of systemic therapy in the development of lung sequelae after conformal radiotherapy in breast cancer patients. / Varga, Zoltán; Cserháti, Adrienn; Kelemen, Gyöngyi; Boda, K.; Thurzó, L.; Kahán, Z.

In: International Journal of Radiation Oncology Biology Physics, Vol. 80, No. 4, 15.07.2011, p. 1109-1116.

Research output: Contribution to journalArticle

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abstract = "Purpose: To analyze the risk of radiogenic lung damage in breast cancer patients after conformal radiotherapy and different forms of systemic treatment. Methods and Materials: In 328 patients receiving sequential taxane-based chemotherapy, concomitant hormone therapy (tamoxifen or aromatase inhibitors), or no adjuvant systemic therapy, symptomatic and asymptomatic lung sequelae were prospectively evaluated via the detection of visible CT abnormalities, 3 months or 1 year after the completion of the radiotherapy. Results: Significant positive associations were detected between the development of both pneumonitis and fibrosis of Grade 1 and patient age, ipsilateral mean lung dose, volume of the ipsilateral lung receiving 20 Gy, and irradiation of the regional lymph nodes. In multivariate analysis, age and mean lung dose proved to be independent predictors of early (odds ratio [OR] = 1.035, 95{\%} confidence interval [CI] 1.011-1.061 and OR = 1.113, 95{\%} CI 1.049-1.181, respectively) and late (OR = 1.074, 95{\%} CI 1.042-1.107 and OR = 1.207, 95{\%} CI 1.124-1.295, respectively) radiogenic lung damage, whereas the role of systemic therapy was significant in the development of Grade 1 lung fibrosis (p = 0.01). Among the various forms of systemic therapy, tamoxifen increased the risk of late lung sequelae (OR = 2.442, 95{\%} CI 1.120-5.326, p = 0.025). No interaction was demonstrated between the administration of systemic therapy and the other above-mentioned parameters as regards the risk of radiogenic lung damage. Conclusions: Our analyses demonstrate the independent role of concomitant tamoxifen therapy in the development of radiogenic lung fibrosis but do not suggest such an effect for the other modes of systemic treatment.",
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