Mehmet Hakan DOĞAN, Melike DEMİR, Pakize Gamze ERTEN BUCAKTEPE, Mehmet KÜÇÜKÖNER, Seyit Burhanedtin ZINCIRCIOĞLU, Fatma TEKE, Memik TEKE, Mehmet Ali KAYA

Evaluation of Pulmonary Function After Radiotherapy Using Helical Tomotherapy for Breast Cancer Treatment: Prospective Study

OBJECTIVE Purpose of the present study was to investigate acute pulmonary changes using pulmonary function tests (PFTs) after breast cancer irradiation with helical tomotherapy (HT). METHODS Forty patients were included in this study. Pretreatment and 3 months after completion of radiotherapy (RT), values of forced vital capacity (FVC), forced expiratory volume in first second (FEV1), and FEV1/ FVC ratio were measured and recorded. RESULTS Restrictive pattern was seen in 4 patients in baseline PFTs and moderate deterioration was observed in their measurements of PFT at 3 months after RT. Obstructive pattern was defined in only 1 patient in baseline PFTs and it remained unchanged after RT. Mild obstructive pattern in 4 patients and mild restrictive pattern in 3 patients had developed at 3 months after RT. CONCLUSION Minimal changes that result in mild restrictive and obstructive pattern in PFTs can be seen in acute phase after RT with HT.

PDF

___

1. Davis SD, Yankelevitz DF, Henschke CI. Radiation effects on the lung: clinical features, pathology, and imaging findings. AJR Am J Roentgenol 1992;159(6):1157- 64.
2. Crapo RO. Pulmonary-function testing. N Engl J Med 1994;331(1):25-30.
3. Marks LB, Yu X, Vujaskovic Z, Small W Jr, Folz R, Anscher MS. Radiation-induced lung injury. Semin Radiat Oncol 2003;13(3):333-45.
4. Cendales R, Schiappacasse L, Schnitman F, García G, Marsiglia H. Helical tomotherapy in patients with breast cancer and complex treatment volumes. Clin Transl Oncol 2011;13(4):268-74.
5. Goddu SM, Chaudhari S, Mamalui-Hunter M, Pechenaya OL, Pratt D, Mutic S, et al. Helical tomotherapy planning for left-sided breast cancer patients with positive lymph nodes: comparison to conventional multiport breast technique. Int J Radiat Oncol Biol Phys 2009;73:1243-51.
6. Dogan N, Cuttino L, Lloyd R, Bump EA, Arthur DW. Optimized dose coverage of regional lymph nodes in breast cancer: the role of intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 2007;68(4):1238- 50.
7. Van Parijs H, Miedema G, Vinh-Hung V, Verbanck S, Adriaenssens N, Kerkhove D, et al. Short course radiotherapy with simultaneous integrated boost for stage I-II breast cancer, early toxicities of a randomized clinical trial. Radiat Oncol 2012;7:80..
8. Jeba J, Isiah R, Subhashini J, Backianathan S, Thangakunam B, Christopher DJ. Radiation Pneumonitis After Conventional Radiotherapy For Breast Cancer: A Prospective Study. J Clin Diagn Res 2015;9(7):XC01- XC05.
9. Krengli M, Sacco M, Loi G, Masini L, Ferrante D, Gambaro G, et al. Pulmonary changes after radiotherapy for conservative treatment of breast cancer: a prospective study. Int J Radiat Oncol Biol Phys 2008;70(5):1460-7.
10.Kubo A, Osaki K, Kawanaka T, Furutani S, Ikushima H, Nishitani H. Risk factors for radiation pneumonitis caused by whole breast irradiation following breastconserving surgery. J Med Invest 2009;56(3-4):99-110.
11.Schytte T, Bentzen SM, Brink C, Hansen O. Changes in pulmonary function after definitive radiotherapy for NSCLC. Radiother Oncol J Eur Soc Ther Radiol Oncol 2015;117:23-8.
12.Stone B, Mangona VS, Johnson MD, Ye H, Grills IS. Changes in Pulmonary Function Following ImageGuided Stereotactic Lung Radiotherapy: Neither Lower Baseline Nor Post-SBRT Pulmonary Function Are Associated with Worse Overall Survival. J Thorac Oncol 2015;10(12):1762-9.
13.Wang S, Liao Z, Wei X, Liu HH, Tucker SL, Hu CS, et al. Analysis of clinical and dosimetric factors associated with treatment-related pneumonitis (TRP) in patients with non-small-cell lung cancer (NSCLC) treated with concurrent chemotherapy and three-dimensional conformal radiotherapy (3D-CRT). Int J Radiat Oncol Biol Phys 2006;66(5):1399-407.
14.Chow TL, Louie AV, Palma DA, D'Souza DP, Perera F, Rodrigues GB, et al. Radiation-induced lung injury after concurrent neoadjuvant chemoradiotherapy for locally advanced breast cancer. Acta Oncol 2014;53(5):697-701.
15.Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J 2005;26(5):948-68.
16.Gokula K, Earnest A, Wong LC. Meta-analysis of incidence of early lung toxicity in 3-dimensional conformal irradiation of breast carcinomas. Radiat Oncol 2013;8:268.
17.Toma CL, Ciprut T, Bugarin S, Roşca D, Bogdan MA. Radiation induced lung injuries secondary to radiotherapy for breast cancer. [Article in Romanian] Pneumologia 2011;60(1):40-6. [Abstract]
18.Lind PA, Wennberg B, Gagliardi G, Fornander T. Pulmonary complications following different radiotherapy techniques for breast cancer, and the association to irradiated lung volume and dose. Breast Cancer Res Treat 2001;68(3):199-210.
19.Vahid B, Marik PE. Pulmonary complications of novel antineoplastic agents for solid tumors. Chest 2008;133(2):528-38.
20.Ramanathan RK, Reddy VV, Holbert JM, Belani CP. Pulmonary infiltrates following administration of paclitaxel. Chest 1996;110(1):289-92.
21.Suzaki N, Hiraki A, Takigawa N, Ueoka H, Tanimoto Y, Kozuki T, et al. Severe interstitial pneumonia induced by paclitaxel in a patient with adenocarcinoma of the lung. Acta Med Okayama 2006;60(5):295-8.
22.Weiss RB, Donehower RC, Wiernik PH, Ohnuma T, Gralla RJ, Trump DL et al. Hypersensitivity reactions from taxol. J Clin Oncol Off J Am Soc Clin Oncol 1990;8:1263-8.
23.Chie EK, Shin KH, Kim DY, Kim T-H, Kang H-S, Lee ES, et al. Radiation Pneumonitis after Adjuvant Radiotherapy for Breast Cancer: A Volumetric Analysis Using CT Simulator. J Breast Cancer 2009;12:73.
24.Onal C, Oymak E, Kotek A, Efe E, Arslan G. Correlation of conventional and conformal plan parameters for predicting radiation pneumonitis in patients treated with breast cancer. J Breast Cancer 2012;15:320-8.
25.Bjermer L, Franzén L, Littbrand B, Nilsson K, Angström T, Henriksson R. Effects of smoking and irradiated volume on inflammatory response in the lung of irradiated breast cancer patients evaluated with bronchoalveolar lavage. Cancer Res 1990;50(7):2027-30.