Changes in pulmonary function after incidental lung irradiation for breast cancer: A prospective study
- Department of Radiation Oncology, Puerta del Mar University Hospital, Cadiz (Spain)
- Department of Radiation Oncology, Albacete University Hospital, Albacete (Spain)
- Department of Pneumology, Puerta del Mar University Hospital, Cadiz (Spain)
- Department of Radiation Physics, San Cecilio University Hospital, Granada (Spain)
- Department of Radiation Physics, Puerta del Mar University Hospital, Cadiz (Spain)
Purpose: The aim of this study was to analyze changes in pulmonary function after radiation therapy (RT) for breast cancer. Methods and Materials: A total of 39 consecutive eligible women, who underwent postoperative irradiation for breast cancer, were entered in the study. Spirometry consisting of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV{sub 1}), carbon monoxide diffusing capacity (DLCO), and gammagraphic (ventilation and perfusion) pulmonary function tests (PFT) were performed before RT and 6, 12, and 36 months afterwards. Dose-volume and perfusion-weighted parameters were obtained from 3D dose planning: Percentage of lung volume receiving more than a threshold dose (V{sub i}) and between 2 dose levels (V{sub (i-j)}). The impact of clinical and dosimetric parameters on PFT changes ({delta}PFT) after RT was evaluated by Pearson correlation coefficients and stepwise lineal regression analysis. Results: No significant differences on mean PFT basal values (before RT) with respect to age, smoking, or previous chemotherapy (CT) were found. All the PFT decreased at 6 to 12 months. Furthermore FVC, FEV{sub 1}, and ventilation recovered almost to their previous values, whereas DLCO and perfusion continued to decrease until 36 months (-3.3% and -6.6%, respectively). Perfusion-weighted and interval-scaled dose-volume parameters (pV{sub (i-j)}) showed better correlation with {delta}PFT (only {delta}perfusion reached statistically significance at 36 months). Multivariate analysis showed a significant relation between pV{sub (10-20)} and {delta}perfusion at 3 years, with a multiple correlation coefficient of 0.48. There were no significant differences related to age, previous chemotherapy, concurrent tamoxifen and smoking, although a tendency toward more perfusion reduction in older and nonsmoker patients was seen. Conclusions: Changes in FVC, FEV{sub 1} and ventilation were reversible, but not the perfusion and DLCO. We have not found a conclusive mathematical predictive model, provided that the best model only explained 48% of the variability. We suggest the use of dose-perfused volume and interval-scaled parameters (i.e., pV{sub (10-20)}) for further studies.
- OSTI ID:
- 20850018
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 65, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2006.03.008; PII: S0360-3016(06)00413-5; Copyright (c) 2006 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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