Role of Systemic Therapy in the Development of Lung Sequelae After Conformal Radiotherapy in Breast Cancer Patients

Journal Article · Fri Jul 15 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.03.044· OSTI ID:21587603

Varga, Zoltan; Cserhati, Adrienn; Kelemen, Gyoengyi ^[1]; Boda, Krisztina ^[2]; Thurzo, Laszlo ^[1]; Kahan, Zsuzsanna ^[1]

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1. Department of Oncotherapy, University of Szeged, Szeged (Hungary)
2. Department of Medical Informatics, University of Szeged, Szeged (Hungary)

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.

• OSTI ID: 21587603
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 80, Issue 4; Other Information: DOI: 10.1016/j.ijrobp.2010.03.044; PII: S0360-3016(10)00533-X; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
CHEMOTHERAPY
ENZYME INHIBITORS
FIBROSIS
HAZARDS
HORMONES
LUNGS
LYMPH NODES
MAMMARY GLANDS
MULTIVARIATE ANALYSIS
NEOPLASMS
PATIENTS
PNEUMONITIS
RADIATION DOSES
RADIOTHERAPY
TAMOXIFEN
BODY
DISEASES
DOSES
GLANDS
LYMPHATIC SYSTEM
MATHEMATICS
MEDICINE
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PATHOLOGICAL CHANGES
RADIOLOGY
RESPIRATORY SYSTEM
STATISTICS
THERAPY