The Risk of Early and Late Lung Sequelae After Conformal Radiotherapy in Breast Cancer Patients

Z. Kahán, Melinda Csenki, Zoltán Varga, Elemér Szil, Adrienn Cserháti, Attila Balogh, Zsófia Gyulai, Y. Mándi, K. Boda, L. Thurzó

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Purpose: To study the risks of early and late radiogenic lung damage in breast cancer patients after conformal radiotherapy. Methods and Materials: Radiogenic lung sequelae were assessed prospectively in 119 patients by means of clinical signs, radiologic abnormalities, and the mean density change (MDC) of the irradiated lung on CT. Results: Significant positive associations were detected between the development of lung abnormalities 3 months or 1 year after the radiotherapy and the age of the patient, the ipsilateral mean lung dose (MLD), the radiation dose to 25% of the ipsilateral lung (D25%) and the volume of the ipsilateral lung receiving 20 Gy (V20 Gy). The irradiation of the axillary and supraclavicular lymph nodes favored the development of pneumonitis but not that of fibrosis. No relation was found between the preradiotherapy plasma TGF-β level and the presence of radiogenic lung damage. At both time points, MDC was strongly related to age. Significant positive associations were demonstrated between the risks of pneumonitis or fibrosis and the age of the patient, MLD, D25%, and V20 Gy. A synergistic effect of MLD, D25%, and V20 Gy with age in patients older than 59 years is suggested. Conclusion: Our analyses indicate that the risks of early and late radiogenic lung sequelae are strongly related to the age of the patient, the volume of the irradiated lung, and the dose to it.

Original languageEnglish
Pages (from-to)673-681
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume68
Issue number3
DOIs
Publication statusPublished - Jul 1 2007

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Conformal Radiotherapy
breast
lungs
radiation therapy
cancer
Breast Neoplasms
Lung
dosage
fibrosis
abnormalities
radiogenic materials
Pneumonia
Fibrosis
damage
lymphatic system

Keywords

  • Breast cancer
  • Conformal radiotherapy
  • Lung density
  • Radiation pneumonitis
  • Radiogenic lung fibrosis
  • Smoking
  • TGF-β

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

The Risk of Early and Late Lung Sequelae After Conformal Radiotherapy in Breast Cancer Patients. / Kahán, Z.; Csenki, Melinda; Varga, Zoltán; Szil, Elemér; Cserháti, Adrienn; Balogh, Attila; Gyulai, Zsófia; Mándi, Y.; Boda, K.; Thurzó, L.

In: International Journal of Radiation Oncology Biology Physics, Vol. 68, No. 3, 01.07.2007, p. 673-681.

Research output: Contribution to journalArticle

Kahán, Z. ; Csenki, Melinda ; Varga, Zoltán ; Szil, Elemér ; Cserháti, Adrienn ; Balogh, Attila ; Gyulai, Zsófia ; Mándi, Y. ; Boda, K. ; Thurzó, L. / The Risk of Early and Late Lung Sequelae After Conformal Radiotherapy in Breast Cancer Patients. In: International Journal of Radiation Oncology Biology Physics. 2007 ; Vol. 68, No. 3. pp. 673-681.
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AB - Purpose: To study the risks of early and late radiogenic lung damage in breast cancer patients after conformal radiotherapy. Methods and Materials: Radiogenic lung sequelae were assessed prospectively in 119 patients by means of clinical signs, radiologic abnormalities, and the mean density change (MDC) of the irradiated lung on CT. Results: Significant positive associations were detected between the development of lung abnormalities 3 months or 1 year after the radiotherapy and the age of the patient, the ipsilateral mean lung dose (MLD), the radiation dose to 25% of the ipsilateral lung (D25%) and the volume of the ipsilateral lung receiving 20 Gy (V20 Gy). The irradiation of the axillary and supraclavicular lymph nodes favored the development of pneumonitis but not that of fibrosis. No relation was found between the preradiotherapy plasma TGF-β level and the presence of radiogenic lung damage. At both time points, MDC was strongly related to age. Significant positive associations were demonstrated between the risks of pneumonitis or fibrosis and the age of the patient, MLD, D25%, and V20 Gy. A synergistic effect of MLD, D25%, and V20 Gy with age in patients older than 59 years is suggested. Conclusion: Our analyses indicate that the risks of early and late radiogenic lung sequelae are strongly related to the age of the patient, the volume of the irradiated lung, and the dose to it.

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