Role of Systemic Therapy in the Development of Lung Sequelae After Conformal Radiotherapy in Breast Cancer Patients
| Autor: | Krisztina Boda, Adrienn Cserháti, Zoltán Varga, Gyöngyi Kelemen, Zsuzsanna Kahán, László Thurzó |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Time Factors medicine.medical_treatment Antineoplastic Agents Breast Neoplasms Gastroenterology Breast cancer Internal medicine Odds Ratio medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Lung Aged Pneumonitis Analysis of Variance Radiation Aromatase Inhibitors business.industry Smoking Cancer Radiotherapy Dosage Middle Aged medicine.disease Surgery Radiation Pneumonitis Radiation therapy Tamoxifen medicine.anatomical_structure Oncology Concomitant Female Hormone therapy Radiotherapy Conformal Tomography X-Ray Computed business medicine.drug |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 80:1109-1116 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2010.03.044 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|