Radiation-induced lung injury after breast cancer treatment: incidence in the CANTO-RT cohort and associated clinical and dosimetric risk factors.

Autor:	Gueiderikh A; Gustave Roussy, Radiation Therapy Department, Villejuif, France., Sarrade T; Tenon Hospital, Radiotherapy Department, Paris, France., Kirova Y; Department of Radiation Oncology, Institut Curie, Paris, France.; University Versailles, St. Quentin, France., De La Lande B; Department of Radiation Oncology, Institut Curie, Saint Cloud, France., De Vathaire F; Gustave Roussy, Comprehensive Cancer Research Center, Villejuif, France.; Centre for Research in Epidemiology and Population Health, U1018 Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France.; Paris-Saclay University, Unité Mixte de Recherche (UMR) 1018, Villejuif, France., Auzac G; Gustave Roussy, Radiation Therapy Department, Villejuif, France., Martin AL; UNICANCER, Data Department, Kremlin Bicêtre, France., Everhard S; UNICANCER, Data Department, Kremlin Bicêtre, France., Meillan N; Centre for Research in Epidemiology and Population Health, U1018 Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France.; Paris-Saclay University, Gustave Roussy, Institut National de la Santé et de la Recherche Médicale (INSERM) 1030, Villejuif, France.; Radiation Therapy Department, CH Victor Dupouy, Argenteuil, France., Bourgier C; Montpellier University, Montpellier, France.; Institut de Recherche en Cancérologie de Montpellier (IRCM), Institut National de la Santé et de la Recherche Médicale (INSERM) U1194, Montpellier, France.; Fédération Universitaire d'Oncologie Radiothérapie d'Occitanie Méditerranée, Institut régional du Cancer Montpellier (ICM), Montpellier, France., Benyoucef A; Radiation Therapy Department, Henri Becquerel Center, Rouen, France., Lacornerie T; Centre Oscar Lambret, Academic Department of Radiation Oncology, 3 rue Combemale, Lille, France., Pasquier D; Centre Oscar Lambret, Academic Department of Radiation Oncology, 3 rue Combemale, Lille, France.; Univ. Lille, &, Centre National de la Recherche Scientifique (CNRS), Centrale Lille, Unité Mixte de Recherche (UMR) 9189 - Centre de Recherche en Informatique, Signal et Automatique de Lille (CRIStAL), Lille, France., Racadot S; Radiotherapy Department, Centre Léon Bérard, Lyon, France., Moignier A; Radiotherapy Department, Institut de Cancérologie de l'Ouest, Nantes, France., Paris F; Radiotherapy Department, Institut de Cancérologie de l'Ouest, Nantes, France.; Nantes Université, Nantes - Angers Cancer and Immunology Research Center (CRCI2NA), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Nantes, France., André F; Gustave Roussy, Medical Oncology Department, Villejuif, France.; Paris-Saclay University, Gustave Roussy, Institut National de la Santé et de la Recherche Médicale (INSERM) U981, Villejuif, France., Deutsch E; Gustave Roussy, Radiation Therapy Department, Villejuif, France.; Paris-Saclay University, Gustave Roussy, Institut National de la Santé et de la Recherche Médicale (INSERM) 1030, Villejuif, France., Duchemann B; Avicenne Hospital, Thoracic Oncology, Bobigny, France., Allodji RS; Gustave Roussy, Comprehensive Cancer Research Center, Villejuif, France.; Centre for Research in Epidemiology and Population Health, U1018 Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France.; Paris-Saclay University, Unité Mixte de Recherche (UMR) 1018, Villejuif, France., Rivera S; Gustave Roussy, Radiation Therapy Department, Villejuif, France.; Paris-Saclay University, Gustave Roussy, Institut National de la Santé et de la Recherche Médicale (INSERM) 1030, Villejuif, France.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2023 Jun 29; Vol. 13, pp. 1199043. Date of Electronic Publication: 2023 Jun 29 (Print Publication: 2023).
DOI:	10.3389/fonc.2023.1199043
Abstrakt:	Purpose: Radiation-induced lung injury (RILI) is strongly associated with various clinical conditions and dosimetric parameters. Former studies have led to reducing radiotherapy (RT) doses to the lung and have favored the discontinuation of tamoxifen during RT. However, the monocentric design and variability of dosimetric parameters chosen have limited further improvement. The aim of our study was to assess the incidence of RILI in current practice and to determine clinical and dosimetric risk factors associated with RILI occurrence. Material and Methods: Data from 3 out of the 10 top recruiting centers in CANTO-RT, a subset of the CANTO prospective longitudinal cohort (NCT01993498), were retrospectively analyzed for RILI occurrence. This cohort, which recruited invasive cT0-3 cN0-3 M0 breast cancer patients from 2012 to 2018, prospectively recorded the occurrence of adverse events by questionnaires and medical visits at the end of, and up to 60 months after treatment. RILI adverse events were defined in all patients by the association of clinical symptoms and compatible medical imaging. Results: RILI was found in 38/1565 (2.4%) patients. Grade II RILI represented 15/38 events (39%) and grade III or IV 2/38 events (6%). There were no grade V events. The most frequently used technique for treatment was 3D conformational RT (96%). In univariable analyses, we confirmed the association of RILI occurrence with pulmonary medical history, absence of cardiovascular disease medical history, high pT and pN, chemotherapy use, nodal RT. All dosimetric parameters were highly correlated and had close predictive value. In the multivariable analysis adjusted for chemotherapy use and nodal involvement, pulmonary medical history (OR=3.05, p<0.01) and high V30 Gy (OR=1.06, p=0.04) remained statistically significant risk factors for RILI occurrence. V30 Gy >15% was significantly associated with RILI occurrence in a multivariable analysis (OR=3.07, p=0.03). Conclusion: Our study confirms the pulmonary safety of breast 3D RT in CANTO-RT. Further analyses with modern radiation therapy techniques such as IMRT are needed. Our results argue in favor of a dose constraint to the ipsilateral lung using V30 Gy not exceeding 15%, especially in patients presenting pulmonary medical history. Pulmonary disease records should be taken into account for RT planning. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Gueiderikh, Sarrade, Kirova, De La Lande, De Vathaire, Auzac, Martin, Everhard, Meillan, Bourgier, Benyoucef, Lacornerie, Pasquier, Racadot, Moignier, Paris, André, Deutsch, Duchemann, Allodji and Rivera.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu