Radiation-induced lung injury in breast cancer patients after breast conservation therapy


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Abstract

Aim: the problem of postradiation lung injury is extremely topical, because of the close proximity to vital organs and the need of the significant part of tissue to receive the high dose of radiation in patients with breast cancer (BC). The aim of the analysis is to determine the frequency, severity of radiation damage to the lung tissue in women with BC, the frequency dependence on the technology of radiation therapy (RT) and the dose of radiation exposure, using 2D-conventional and 3D-conformal radiation therapy.materials and methods: we analyzed the data concerning the studies of thoracic organs (X-ray and computer tomography investigation) in 513 Tis-2N0-2M0 BC patients, receiving complex organ sparing treatment between 1996 and 2013 years. 318 patients were treated with postoperative 2D-conventional radiotherapy to a dose of 50 Gy, 195 patients - with 3D-conformal radiotherapy.results: we indicated that radiologically detected lung injury occur equally often in case of using 2D and 3D radiation therapy: 27,4 and 28,7%, respectively ( p >0,05); their frequency was significantly increased by 20-24% during radiotherapy only of the mammary gland and 37-41% - when doctors added the radiotherapy of cervical, supra - and infraclavicular regions. We showed that the risk of radiation pneumonitis in the ipsilateral lung was more than 25% and was significantly increased on the V20 increasing of the average dose to the lung more than 15 Gy.

About the authors

O P Trofimova

N.N.Blokhin Russian Cancer Research Center

Email: dr.trofimova@mail.ru
канд. мед. наук, вед. науч. сотр. радиологического отд-ния ФГБНУ РОНЦ им. Н.Н.Блохина 115478, Russian Federation, Moscow, Kashirskoe sh., d.23

S I Tkachev

N.N.Blokhin Russian Cancer Research Center

д-р мед. наук, проф., зав. радиологическим отд-нием ФГБНУ РОНЦ им. Н.Н.Блохина 115478, Russian Federation, Moscow, Kashirskoe sh., d.23

S M Ivanov

N.N.Blokhin Russian Cancer Research Center

канд. мед. наук, ст. науч. сотр. радиологического отд-ния ФГБНУ РОНЦ им. Н.Н.Блохина 115478, Russian Federation, Moscow, Kashirskoe sh., d.23

V L Utkina

N.N.Blokhin Russian Cancer Research Center

врач-рентгенолог рентгенодиагностического отд-ния НИИ клинической онкологии ФГБНУ РОНЦ им. Н.Н.Блохина 115478, Russian Federation, Moscow, Kashirskoe sh., d.23

O I Cheban

N.N.Blokhin Russian Cancer Research Center

канд. мед. наук, врач-терапевт консультативной группы консультативного отд-ния НИИ клинической онкологии ФГБНУ РОНЦ им. Н.Н.Блохина 115478, Russian Federation, Moscow, Kashirskoe sh., d.23

V V Glebovskaya

N.N.Blokhin Russian Cancer Research Center

канд. мед. наук, ст. науч. сотр. радиологического отд-ния ФГБНУ РОНЦ им. Н.Н.Блохина 115478, Russian Federation, Moscow, Kashirskoe sh., d.23

References

  1. Аксель Е.М. Заболеваемость и смертность от рака молочной железы в России. Материалы конференции «Рак молочной железы». 22-24 января 2014 г. М., 2014; с. 34-8.
  2. Бардычев М.С, Кацалап С.Н. Местные лучевые повреждения: особенности патогенеза, диагностика и лечение. Вопр. онкологии. 1995; 41 (2): 99-101.
  3. Куницкая В.И. Оценка лучевых повреждений легочной ткани при лечении рака легкого и лимфомы Ходжкина. Дис. … канд. мед. наук. Челябинск, 2009; с. 32-3.
  4. Зорина Л.А. Поздние лучевые повреждения легких после лечения рака молочной железы. Дис. … канд. мед. наук. Обнинск, 1988; с.172.
  5. Арустамян Л.Ю. Лечение повреждений легких у больных раком молочной железы с использованием искусственного магнитного поля. Дис. … канд. мед. наук. М., 2001; с. 14-8; 58-64.
  6. Бардычев М.С., Пасов В.В. Лечение вторичных лучевых повреждений после комбинированного лечения рака молочной железы. Рус. онкол. журн. 1998; 1: 18-21.
  7. Gibson Р.G, Morgan G.W, Bryant D.H. Radiation-Induced Lung Injury: A Hypersensitivity Pneumonitis? Ann Intern Med 1988; 109 (4): 288-91.
  8. Cox J.D, Stetz J, Pajak T.F. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys 1995; 31: 1341-6.
  9. Marks L.B. Use of normal tissue complication probability models n the clinic. Int J Radiat Oncol Biol Phys 2010; 76 (3 Suppl.): S10-9.
  10. Trewet C.B. Interstitial lung diseases/Pulmonary fibrosis, in: Drug-Induced Diseases: Prevention, Detection, and Management. 2-nd Edition. Ed. by J.E.Tisdale, D.A.Miller. Published by the American Society of Health-System Pharmacists, Bethesda, MD, 2010; 21: 359-77.
  11. Постников С.С., Грацианская А.Н., Костылева М.Н. Пневмотоксичность лекарственных средств. Практика педиатра. 2013; с. 56-8.
  12. Мc Donald S, Rubin P, Phillips T.L, Marks L.B. Injury to the lung from cancer therapy: clinical syndromes, measurable endpoints, and potential scoring systems. Int J Radiat Oncol Biol Phys 1995; 8: 1187- 203.
  13. Gokula К, Earnest А, Wong L.Ch. Meta - analysis of incidence of early lung toxicity in 3-dimensional conformal irradiation of breast carcinomas. Radiation Oncol 2013; 8: 268-74.

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