Reduction of radiation pneumonitis by V20-constraints in breast cancer
<p>Abstract</p> <p>Introduction</p> <p>Adjuvant local-regional radiotherapy (LRRT) is routinely recommended for breast cancer patients. It is well known being related to pulmonary side-effects. We studied post-RT radiological changes on X-ray and CT, and correlated the...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2010-10-01
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| Series: | Radiation Oncology |
| Online Access: | http://www.ro-journal.com/content/5/1/99 |
| _version_ | 1818553005075595264 |
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| author | Svane Gunilla Wennberg Berit Goldman Ulla Bylund Håkan Lind Pehr |
| author_facet | Svane Gunilla Wennberg Berit Goldman Ulla Bylund Håkan Lind Pehr |
| author_sort | Svane Gunilla |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Introduction</p> <p>Adjuvant local-regional radiotherapy (LRRT) is routinely recommended for breast cancer patients. It is well known being related to pulmonary side-effects. We studied post-RT radiological changes on X-ray and CT, and correlated the findings with Quality of Life (QoL), common dosimetric factors and co-variates. The results were compared with a previously reported cohort of 137 irradiated women.</p> <p>Methods</p> <p>88 women underwent chest X-ray and CT pre-and 4-5 months after 3-D planned LRRT, minimizing the dose to the ipsilateral lung to V<sub>20 </sub>< 30%. The lung field was divided into 3 regions and the development of post-RT density changes were graded (0-3). Patients with radiological changes were compared with non-responders. Clinical symptoms were registered and data on patient and treatment related co-variates were gathered prospectively. The ipsilateral lung dosimetric factors V<sub>13</sub>, V<sub>20</sub>, V<sub>30 </sub>and mean dose were calculated and QoL was assessed before and 4 months after RT.</p> <p>Results</p> <p>The use of dose-volume constraints significally reduced moderate-severe radiological changes on chest X-ray compared with our earlier study (Chi square trend test: p < 0.001). Symptomatic pneumonitis was also rare in the present study. No agreement was found between CT and chest X-ray as diagnostic tools for post-RT pneumonitis. V<sub>13 </sub>correlated independently with radiological changes on CT (logistic regression: p = 0.04; ROC area: 0.7). The Co-variates smoking habits, age, chemotherapy, endocrine or trastuzumab therapy did not influence the outcome on multivariate analysis. QoL changes in physical function, i.e. fatigue, dyspnoea were not detected but there was a trend for a worse recovery after chemotherapy in patients with high V<sub>13 </sub>(Spearman Rank Correlation: p < 0.05).</p> <p>Conclusions</p> <p>The use of dose-volume constraints significantly reduced post-RT radiological changes on chest X-ray in LRRT for BC. The lung changes on CT were also generally limited when we used this strategy and was not always picked up on chest X-ray. Variation in V<sub>13 </sub>alone was correlated with occurrence of lung changes on CT.</p> |
| first_indexed | 2024-12-12T09:20:25Z |
| format | Article |
| id | doaj.art-2c7fea921b35456fa774793b826d97b3 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-12T09:20:25Z |
| publishDate | 2010-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-2c7fea921b35456fa774793b826d97b32022-12-22T00:29:14ZengBMCRadiation Oncology1748-717X2010-10-01519910.1186/1748-717X-5-99Reduction of radiation pneumonitis by V20-constraints in breast cancerSvane GunillaWennberg BeritGoldman UllaBylund HåkanLind Pehr<p>Abstract</p> <p>Introduction</p> <p>Adjuvant local-regional radiotherapy (LRRT) is routinely recommended for breast cancer patients. It is well known being related to pulmonary side-effects. We studied post-RT radiological changes on X-ray and CT, and correlated the findings with Quality of Life (QoL), common dosimetric factors and co-variates. The results were compared with a previously reported cohort of 137 irradiated women.</p> <p>Methods</p> <p>88 women underwent chest X-ray and CT pre-and 4-5 months after 3-D planned LRRT, minimizing the dose to the ipsilateral lung to V<sub>20 </sub>< 30%. The lung field was divided into 3 regions and the development of post-RT density changes were graded (0-3). Patients with radiological changes were compared with non-responders. Clinical symptoms were registered and data on patient and treatment related co-variates were gathered prospectively. The ipsilateral lung dosimetric factors V<sub>13</sub>, V<sub>20</sub>, V<sub>30 </sub>and mean dose were calculated and QoL was assessed before and 4 months after RT.</p> <p>Results</p> <p>The use of dose-volume constraints significally reduced moderate-severe radiological changes on chest X-ray compared with our earlier study (Chi square trend test: p < 0.001). Symptomatic pneumonitis was also rare in the present study. No agreement was found between CT and chest X-ray as diagnostic tools for post-RT pneumonitis. V<sub>13 </sub>correlated independently with radiological changes on CT (logistic regression: p = 0.04; ROC area: 0.7). The Co-variates smoking habits, age, chemotherapy, endocrine or trastuzumab therapy did not influence the outcome on multivariate analysis. QoL changes in physical function, i.e. fatigue, dyspnoea were not detected but there was a trend for a worse recovery after chemotherapy in patients with high V<sub>13 </sub>(Spearman Rank Correlation: p < 0.05).</p> <p>Conclusions</p> <p>The use of dose-volume constraints significantly reduced post-RT radiological changes on chest X-ray in LRRT for BC. The lung changes on CT were also generally limited when we used this strategy and was not always picked up on chest X-ray. Variation in V<sub>13 </sub>alone was correlated with occurrence of lung changes on CT.</p>http://www.ro-journal.com/content/5/1/99 |
| spellingShingle | Svane Gunilla Wennberg Berit Goldman Ulla Bylund Håkan Lind Pehr Reduction of radiation pneumonitis by V20-constraints in breast cancer Radiation Oncology |
| title | Reduction of radiation pneumonitis by V20-constraints in breast cancer |
| title_full | Reduction of radiation pneumonitis by V20-constraints in breast cancer |
| title_fullStr | Reduction of radiation pneumonitis by V20-constraints in breast cancer |
| title_full_unstemmed | Reduction of radiation pneumonitis by V20-constraints in breast cancer |
| title_short | Reduction of radiation pneumonitis by V20-constraints in breast cancer |
| title_sort | reduction of radiation pneumonitis by v20 constraints in breast cancer |
| url | http://www.ro-journal.com/content/5/1/99 |
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