title: [Pulmonary reaction to radiation as depicted in chest x-rays following megavolt therapy of breast cancer].
abstract: X-ray radiographs of the thorax of 184 patients with carcinoma of the breast (treatment period 1974-1978) that were taken during radiotherapy and follow-up were examined with respect to X-ray substrate, intensity, and temporary pulmonary reaction to radiotherapy. The therapy applied was "extended-field" irradiation (5-field technique) via 4 MeV linac with total doses of 50-60 Gy and a fractionation of 5 X 2 or 4 X 2.5 Gy/week. After a characteristic latency period of 11-13 weeks without radiomorphological reactions, the first signs of pneumonitis could be observed (stage I); after 14-19 weeks, florid pneumonitis (stage II A) was noted and from week 16 to 21, florid pneumonitis with first signs of regression (stage II B) was observed. After a transitional period (stage III), the pulmonal radioreaction ended with stationary local fibrosis (stage IV). The radioreaction was classified into three stages of severity: "light" regional pneumonitis and fibrosis occurred in 20% and 39% of the cases; a "medium" one occurred in 5% and 6%; and a "severe" reaction was observed in 12% and 4% of the cases. Further expansion of mediastinal or parenchymal areas of shadow after stage II B does not correspond to the dynamic course of pulmonary radioreactions; in these cases, thoracic tumor progression or metastasis must be assumed.
mesh_terms: D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008168:Lung / Q000528:radiation effects*; D011014:Pneumonia / Q000000981:diagnostic imaging* / Q000209:etiology; D013902:Radiography, Thoracic; D011882:Radiotherapy, High-Energy / Q000009:adverse effects*
vernacular_title: Die pulmonale Strahlenreaktion im Röntgenbild des Thorax nach Megavolttherapie bei Mammakarzinom.