title: The effect of pulmonary function of local and loco-regional irradiation for breast cancer.
abstract: Eighty-five patients treated with loco-regional radiotherapy to the breast/chest wall and cervico-axillary nodes, and 16 patients treated with local radiotherapy to the breast/chest wall alone for breast cancer were enrolled in a prospective study to measure the effects of treatment on pulmonary function during the acute phase (10 weeks after completing irradiation) and during the late phase (12 months after completing irradiation). Baseline pulmonary function values were obtained from all patients immediately prior to commencing radiotherapy. Twenty-two patients (25.8%) treated with loco-regional radiotherapy developed transient chest symptoms compared with two patients (12.5%) treated with local radiotherapy (P = 0.11). Patients undergoing loco-regional radiotherapy showed a reduction of mean vital capacity of 0.13 litres (4.2%) (P < 0.0001) during the acute phase and at  1 year a further decrease occurred (P = 0.02) so that mean vital capacity was reduced by 0.18 litres (5.8%) (P < 0.0001) compared to pretreatment values. Mean transfer factor for carbon monoxide (TLCO) was reduced by 0.85 mmol.kPa-1.min-1 [11.9%] (P < 0.0001) during the acute phase and remained unchanged at 1 year. Patients undergoing local radiotherapy to the breast/chest wall alone did not show any significant loss of vital capacity but mean TLCO was reduced during the acute phase by 0.65 mmol.kPa-1.min-1 (8.3%) (P < 0.002) which remained unchanged at 1 year. No significant association was found between impairment of ventilation or gas transfer and respiratory history, smoking history, concurrent respiratory symptoms, age, side treated or physiological pulmonary function in either the acute or late phase. This study has quantified some of the physiological sequelae following local and loco-regional radiotherapy for breast cancer. There is no evidence to suggest that any of the above factors are relevant to deciding which patients should, or should not, be offered local or loco-regional radiotherapy for breast cancer.
authors.affiliation: Department of Clinical Oncology, Western General Hospital, Edinburgh, UK.
authors.forename: P D
authors.initials: PD
authors.lastname: Hardman
authors.forename: P M
authors.initials: PM
authors.lastname: Tweeddale
authors.forename: G R
authors.initials: GR
authors.lastname: Kerr
authors.forename: E D
authors.initials: ED
authors.lastname: Anderson
authors.forename: A
authors.initials: A
authors.lastname: Rodger
mesh_terms: D001943:Breast Neoplasms / Q000532:radiotherapy*; D003371:Cough / Q000453:epidemiology / Q000209:etiology; D004417:Dyspnea / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008168:Lung / Q000528:radiation effects*; D008875:Middle Aged; D011446:Prospective Studies; D011832:Radiation Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D012129:Respiratory Function Tests; D012907:Smoking / Q000453:epidemiology